Speaking at the JP Morgan Healthcare Conference in San Francisco, Mahoney outlined the company’s plans, including a couple of products he expects to significantly drive that planned growth. The plans echoed the sentiment from the company’s September 2023 Investor Day event.
“We continue to aim to be the highest performing differentiated large-cap medtech company,” Mahoney said. “That’s our aim through 2030. There are many key enablers for that.”
At that 2023 Investor Day, Mahoney talked about how the company’s Farapulse and Watchman offerings would drive growth. At JP Morgan, he highlighted those two products as growth drivers — including in conjunction with one another.
Farapulse, the company’s pulsed-field ablation platform for AFib, picked up FDA approval just under one year ago. The latest-generation Watchman FLX Pro received FDA approval in September 2023. Both could help the company further establish a foothold in their respective markets (AFib and left atrial appendage closure).
“In EP, we’ve disrupted and transformed a hot, large market,” Mahoney said. “With Watchman, we created this [LAAC] market over many years.”
More about how Farapulse can drive growth at Boston Scientific
The much-anticipated Farapulse approval last year made Boston Scientific the second company to earn an FDA nod for PFA that treats AFib. It enabled the use of Farapulse in the isolation of pulmonary veins to treat drug-refractory, recurrent, symptomatic, paroxysmal AFib.
Mahoney said that, only 10 months into the Farapulse launch in the U.S., the company can already see heightened interest in the coming years.
According to the CEO, around 20% of global AFib cases took place through PFA in 2024. He expects that number to reach 60% by 2026.
“It’s very rare in medtech to have the largest market in the industry that we estimate here is going to grow 20%. The fastest market within that — the AFib market, we estimate growing 25%. It’s very rare to find the largest market, that happens to be the fastest-growing market, transformed or disrupted.”
Mahoney said the company plans to establish a market share through its strong portfolio, investments and clinical science efforts. In addition to growth in the U.S., the company also has eyes on other geographies — namely China and Japan, Mahoney said.
“We were the lagging No. 4 player in EP — a distant No. 4,” he said. “We expect to be the No. 2 player by midpoint 2025. Our aim is to be the No. 1 player in this global business over the coming years. We have the solutions, the team and the focus to execute on that.”
More on Watchman
With Watchman, Boston Scientific estimates a 20% compound annual growth rate (CAGR) in 2025 with a high market share.
Mahoney said the company continues to fuel portfolio investments and clinical investments to expand its advantage in that area. Vitally, the company sees an opportunity with the concomitant use of Farapulse and Watchman.
“Now we have the ability to do both those procedures at the same time at a reimbursement code that’s very favorable for hospitals,” Mahoney said.
He expects a Watchman label update in the second half of 2025, based on positive results from the OPTION trial.
“Optimizing this in a concomitant procedure is a big winner for hospitals to optimize their workflow and have a patient have two procedures at one setting,” Mahoney said.
The LAA space remains an interesting one to monitor. Watchman currently competes against offerings like Abbott’s Amplatzer Amulet. However, Medtronic threw its hat in the ring with the launch of its Penditure LAA exclusion system in November 2023. That caused worry among AtriCure investors, as AtriCure develops its own LAAC device — the AtriClip.
Conformal Medical is another player in the space, with the company reporting “encouraging” results earlier last year when comparing its CLAAS implant to the Watchman FLX. Meanwhile, Johnson & Johnson made its own LAA play late in 2023 with the $400 million acquisition of Laminar. Laminar’s LAA device aims to completely eliminate the appendage to treat AFib.
Another area of note at Boston Scientific
Elsewhere, Boston Scientific remains active in multiple spaces — none more so than mergers and acquisitions.
The company completed its $1.18 billion acquisition of Silk Road Medical in September 2024, then closed the $3.7 billion buy of Axonics in November.
Silk Road Medical develops products designed to prevent stroke in patients with carotid artery disease. The technology is used in a minimally invasive procedure called transcarotid artery revascularization (TCAR). Axonics is known for its neuromodulation systems, including the fourth-generation R20 rechargeable SNM and recharge-free F15 SNM systems. Both treat urinary and bowel dysfunction by delivering mild electrical pulses to the sacral nerve. The company also offers Bulkamid, a urethral bulking agent for stress urinary incontinence.
To kick off 2025, the company entered the intravascular lithotripsy (IVL) space with the planned acquisition of Bolt Medical. The growing space includes Johnson & Johnson after its $13.3 billion acquisition of Shockwave Medical. Other companies, such as FastWave Medical, Vantis Vascular and Amplitude Vascular are making waves in IVL, too.
