Boston Scientific
(NYSE: BSX)
shares tumbled before hours today despite fourth-quarter results that topped the consensus forecast.
Shares of BSX fell by more than 10% to $81.55 apiece in pre-market trading today. The shares rebounded slightly to $83.68 apiece as the market opened. However, by midday, shares were trading down nearly 15% at $78.45 apiece.
Negative investor reaction could come as a result of underperformance in Electrophysiology, according to Evercore analyst Vijay Kumar said. Boston Scientific reported 35% growth in the unit, but that came in 5% below expectations, the analyst said. Electrophysiology remains a key part of Boston Scientific’s strategy, as Mike Mahoney, chair and CEO, outlined at the J.P. Morgan Healthcare Conference last month.
The Marlborough, Massachusetts-based medtech giant reported profits of $672 million. That equals 45¢ per share on sales of $5.286 billion for the three months ended Dec. 31, 2025.
Boston Scientific recorded an 18.7% bottom-line gain on a sales increase of 15.9%.
Adjusted to exclude one-time items, earnings per share came in at 80¢. That landed 2¢ ahead of expectations on Wall Street. Sales also just topped the forecast as experts projected $5.28 billion in revenue.
“2025 was another exceptional year for Boston Scientific, with our global teams delivering differentiated innovation and high performance that enabled us to exceed our goals,” said Mike Mahoney, chair and CEO, Boston Scientific. “As a direct result of the dedication, consistency and winning spirit of our team, we have impacted millions of patient lives and are well-positioned to continue on our strong growth trajectory well into the future.”
Boston Scientific expects adjusted EPS to range between $3.43 and $3.49 for the full year. It projects sales growth between 10.5% and 11.5%.
More on the Boston Scientific fourth-quarter performance
In the quarter, Boston Scientific saw growth across its business units, with an 18.2% revenue increase in Cardiovascular and 11.7% growth in MedSurg. Urology delivered 13.8% growth, followed by Neuromodulation (11.1%) and Endoscopy (10.1%).
Highlights for the quarter included the closing of a deal to acquire bioenvelope technology from Elutia and an agreement to acquire Nalu Medical (with the deal closing last month). The company also received European approval for its Farapoint catheter, which later received an FDA nod, too. Boston Scientific will also benefit from Medicare coverage for pulsed field ablation (PFA) in ambulatory surgery centers (ASCs), which came in during the three-month period.
During the fourth quarter, Boston Scientific also purchased a new facility in Minnesota and earned new insurance coverage for its Intracept procedure.
The analysts’ take
BTIG analysts Marie Thibault, Sam Eiber and Alexandra Pang today noted that Boston Scientific’s Farapulse and Watchman products missed their fourth-quarter sales expectations. Electrophysiology, they said, missed the forecast by $33 million. Watchman fell $4 million shy of expectations, leading to disappointment after recent strong performances.
“The closely watched Electrophysiology (EP) segment missed consensus by $33M, confirming investor fears the [Boston Scientific] is starting to lose market share in PFA,” the analysts wrote.
The company currently competes against the likes of Medtronic, Johnson & Johnson MedTech, Abbott and Kardium, all of whom have commercially available PFA systems.
According to the analysts, management acknowledged a potential loss of market share in PFA with the entry of competitors. However, Boston Scientific remains confident in remaining the market leader.
“[Boston Scientific] has dazzled investors in the past with its one-two punch of Farapulse and Watchman but we think that era is likely behind us,” the analysts wrote. “Now, broad-based strength from a wider swath of the portfolio is needed to maintain [Boston Scientific’s] reputation as an above-peer growth story. We still think BSX’s diversity, deep product pipeline, and market-leader status with Farapulse and Watchman are worth a premium, but acknowledge the contraction in the company’s valuation multiple.”
