Boston Scientific (NYSE:BSX) today reduced its 2026 guidance despite second-quarter results that came in ahead of the consensus forecast.
The company reduced its revenue outlook from sales growth of 7%–8.5% to between 5.5%–6.5%. This outlook shift follows last quarter’s guidance cut from a range of 10.5%–11.5% growth.
Boston Scientific also lowered its adjusted earnings per share (EPS) guidance from $3.34-$3.41 to $3.28-$3.22.
Investors appeared to take the news in stride as BSX shares remained about the same by midday trading today. The S&P 50 fell nearly 1%. The company’s quarterly earnings report comes just days after it announced significant cost reduction efforts that likely include job cuts down the line.
On the company’s second-quarter earnings call, Chair and CEO Mike Mahoney said: “We updated our guidance in Q1 with a goal of establishing the right baseline for the year. This update today is not the outcome we planned or what you have come to expect from us.”
Mahoney went on to say that quickly-evolving market conditions have challenged the company’s forecasting. He said the guidance reduction reflects a sharp and unexpected slowdown in the U.S. market for the Watchman left atrial appendage closure (LAAC) device. It also points to significant competitive share movement in the U.S. in electrophysiology, where competitors are gaining ground in pulsed field ablation (PFA).
The company’s recently announced restructuring aims to drive cost efficiencies while returning to strong EPS growth in 2028, Mahoney said.
“We’re focused on execution, delivering our 2026 guide, staying disciplined on spending and continuing to fund the areas of the portfolio where we see the strongest long-term opportunity,” he said. “I want to reiterate my confidence in the future of Boston Scientific.”
Details of the quarterly earnings report
For the quarter, the Marlborough, Massachusetts–based medtech giant reported profits of $907 million. That equals 61¢ per share on sales of $5.44 billion for the three months ended June 30, 2026.
Boston Scientific recorded a 13.8% bottom-line gain on a sales increase of 7.5%.
Adjusted to exclude one-time items, earnings per share came in at 86¢. That landed 3¢ ahead of expectations on Wall Street. Sales also topped estimates as experts forecast $5.37 billion in revenue.
The company recorded 5.9% growth in MedSurg in the quarter and 8.3% growth in Cardiovascular. Highlights in the quarter included study results backing its wide-ranging electrophysiology portfolio, the first patient treated in an IVL registry and the meeting of endpoints in a coronary IVL trial. The company also committed $1.5 billion to invest in TAVR developer MiRus during the quarter.
“Our team delivered a solid quarter while continuing to navigate a dynamic environment,” Mahoney said in a news release. “We are focused on disciplined execution and prioritizing investments in our highest-impact opportunities, and we remain confident in Boston Scientific’s long-term growth, anchored by our category leadership strategy and our commitment to meaningful innovation for patients and physicians.”
The analysts’ take
BTIG analysts Marie Thibault, Alexandra Pang and Sam Eiber maintain a “Buy” rating for Boston Scientific despitethe guidance cut. They remain “constructive” on the company, as they said last month when questions continued to circle its financial performance and outlook.
The analysts note that Watchman came in below consensus, delivering $570 million in revenue, while Electrophysiology beat by $10 million (with a total revenue of $916 million).
Thibault, Pang and Eiber say the revised outlook offers a more realistic guide and gives investors a floor for projections. They continue to like Boston Scientific for its high-growth product pipeline and think any indication that Watchman or PFA can perform better than the low expectations should drive stock prices higher.
“We wrote in our earnings preview that we felt there was little BSX could say to surprise to the downside on the Q2 call and with the stock holding in above recent lows despite today’s tough commentary, we think this remains true,” the analysts wrote.
The analysts say they expect both franchises to return to more normalized growth trajectories. However, they note more uncertainty for Watchman, but believe overall evidence should support LAAC as a therapy option.
“We acknowledge that [Boston Scientific’s] era of consistent double-digit organic growth is likely behind it,” the analysts wrote. “However, as we move past 2027, we think [Boston Scientific] can return to higher top-line and low-double-digit EPS growth with what we see as the most differentiated large-cap medtech pipeline.”
Mike Matson & Needham & Co. think the worst-case for Watchman may already be factored into Boston Scientific’s share price.
“Management cited workflow issues (physicians are swamped), but we believe that recent clinical trials and reimbursement are also factors hurting Watchman growth,” Matson said.
