Boston Scientific (NYSE:BSX) today reported first-quarter financial results that came in ahead of the Wall Street forecast.
However, the company cut its adjusted earnings per share (EPS) guidance for 2026, now projecting between $3.34 and $3.41. It previously set its guidance for between $3.43 and $3.49. Additionally, the company slashed its sales forecast from growth between 10.5% and 11.5% to an increase of 7% to 8.5%.
Shares of BSX remained relatively unchanged at $59.63 apiece before the market opened today. However, they were up around 9% at $64.82 at midday. The S&P 500 showed little movement.
On the company’s earnings call, CEO Mike Mahoney said the guidance change reflects “unanticipated headwinds and changing business patterns.”
“Our company and I do not take this change lightly,” Mahoney said. “Boston Scientific takes great pride in ourselves and consistently executing against the guidance and goals we provide. Importantly, we remain convinced in the future of Boston Scientific.”
More about the guidance change
Mahoney said the company’s guidance change is primarily related to three areas: Electrophysiology (EP), led by the Farapulse pulsed field ablation (PFA) platform, the Watchman left atrial appendage closure (LAAC) device, and Urology.
Farapulse was the root of questions around the company’s previous quarterly performance, with analysts saying sales in EP came up short of expectations as more companies, such as Medtronic, Johnson & Johnson MedTech, Abbott and Kardium all gaining share.
Mahoney said today that, while the company remains confident that it can stay in the pole position in the U.S. PFA market, the guidance reflects a larger-than-expected market share erosion.
With Watchman, the company observed an increase in concomitant growth but a deceleration in standalone Watchman procedures.
For Urology, Mahoney said the company suffered in its core business and in neuromodulation, but it believes sacral neuromodulation — highlighted by technology acquired from Axonics — will “be better as the years and quarters go on.” He said the company expects a “below-market year in urology.”
Boston Scientific said its 2026 outlook excludes the impact of foreign currency fluctuations and net sales attributable to certain acquisitions and divestitures.
“While this year has proven to be more challenging than we anticipated, we believe Boston Scientific is competing in the right markets,” Mahoney said.
The analysts’ reaction
BTIG analysts Marie Thibault, Alexandra Pang and Sam Eiber maintain a “Buy” rating for Boston Scientific after the earnings report.
The analysts note that Boston Scientific cut its Watchman outlook to the mid-teens globally for 2026, and they note Urology weakness in kidney stone technology and sacral neuromodulation.
Additionally, the analysts say that management acknowledged pressure on its long-range organic sales target of more than 10%. However, the company stood firm on its margin expansion and adjusted EPS outlook.
The analysts say Boston Scientific remains confident but, after the revised 2026 guidance, the long-range growth outlook looks more like an “upside scenario.”
“We think this reset brings expectations to a level [Boston Scientific] can credibly execute against, and we see the current setup as a better entry point into the story,” the analysts said.
More on the Boston Scientific results
The Marlborough, Massachusetts-based medtech giant reported profits of $1.34 billion. That equals 90¢ per share on sales of $5.2 billion for the three months ended March 31, 2026.
Boston Scientific nearly doubled its profits compared to net income of $674 million in the same period a year ago. It produced a sales increase of 11.6%.
Adjusted to exclude one-time items, earnings per share came in at 80¢. That landed 1¢ ahead of expectations on Wall Street. Sales also topped estimates as experts projected $5.17 million in revenue.
Boston Scientific reported growth across all segments, with Neuromodulation (17.4%) leading the way, followed by Endoscopy (9.4%) and Urology (2.1%). MedSurg, made up by those three units, grew 7.8%, while Cardiovascular revenues increased by 13.5% year over year. Mahoney noted that Urology fell short of expectations, however.
Highlights in the quarter included the announcement of a deal to acquire Penumbra and the completion of deals to buy Nalu Medical and Valencia Technologies.
Boston Scientific also reported positive study findings for Farapulse, then won expanded CE mark for the platform.
The company also reported new data backing its Watchman, Ekos and intravascular ultrasound offerings. Additionally, it received FDA clearance for its Asurys fluid management system.
“Our global team and the strength of our category leadership strategy enabled us to deliver solid results this quarter,” said Mike Mahoney, chair and CEO, Boston Scientific. “We remain focused on executing our long-term strategy and advancing our differentiated pipeline to drive meaningful impact for patients, physicians and hospital systems.”
