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BSX Stock Dips in Premarket Trading Despite Q4 Earnings, Revenue Beat

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Key Takeaways

  • Boston Scientific posted Q4 EPS of 80 cents and revenues of $5.29B, topping estimates as shares fell.
  • BSX expanded gross margin to 69.6% and adjusted operating margin to 24% even as costs and spending rose.
  • Boston Scientific forecasts 2026 sales growth of about 10.5-11.5% and adjusted EPS of $3.43-$3.49.

Boston Scientific Corporation (BSX - Free Report) posted fourth-quarter 2025 adjusted earnings per share (EPS) of 80 cents, up 14.3% from the year-ago figure. The figure beat the Zacks Consensus Estimate by 2.6% and exceeded the company’s adjusted EPS guidance of 77-79 cents.

The quarter’s adjustments included certain amortization expenses, litigation-related net charges and restructuring charges, among others. Reported EPS for the fourth quarter was 45 cents, reflecting a 18.4% rise from the year-ago quarter’s 38 cents.

Full-year adjusted EPS was $3.06, a 21.9% increase from 2024. It also exceeded the Zacks Consensus Estimate by 0.7% and the company’s 2025 guidance range of $3.02-$3.04.

Revenue Details of BSX

Fourth-quarter revenues totaled $5.29 billion, up 15.9% year over year on a reported basis and 14.3% on an operational basis. Organic growth, adjusted for foreign currency fluctuations and certain recent acquisitions and divestments, was 12.7% year over year.

The top line exceeded the Zacks Consensus Estimate by 0.4%. Revenue growth was within the company’s reported growth guidance of 14.5-16.5%.

For 2025, revenues were $20.07 billion, up 19.9% on a reported basis, 19.2% on an operational basis and 15.8% on an organic basis over 2024.

Following the earnings announcement, shares of BSX fell 9.1% in pre-market trading today.

BSX's Q4 Revenues by Regions

In the fourth quarter, revenues rose 17% in the United States on a reported basis (same operationally).

Reported revenues rose 12.4% in Europe, the Middle East and Africa (EMEA) region (up 4.8% operationally) and 15.2% in the Asia Pacific zone (up 14.8% operationally).

Reported revenues increased 15.9% in Latin America and Canada (up 10.4% operationally). Reported revenue growth in emerging markets was 15.4% (up 13% operationally).

Breaking Down BSX's Q4 Revenues by Segments

Boston Scientific recently reorganized its operational structure and aggregated its core businesses into two reportable segments — MedSurg and Cardiovascular. Both these segments generate revenues from the sale of Medical Devices.

MedSurg

MedSurg revenues in the fourth quarter totaled $1.81 billion, up 15.9% year over year on a reported basis (up 12.7% organically).

Within this, the Endoscopy unit generated revenues of $760 million, up 8.2% organically.

Urology revenues amounted to $717 million, reflecting organic growth of 3.2%.

The Neuromodulation business reported $332 million in revenues, highlighting a 9.9% rise organically year over year.

Cardiovascular

The company generates maximum revenues from this segment. Revenues in the fourth quarter totaled $3.48 billion, up 18.2% (reportedly) and 16.1% (organically) year over year.

BSX’s Margin Performance in Q4

The gross margin expanded 172 basis points (bps) year over year to 69.6%. There was a 9.7% rise in the cost of products sold to $1.61 billion in the reported quarter.

Selling, general and administrative expenses rose 13.8% to $1.83 billion. Research and development expenses rose 23.7% to $569 million. Royalty expenses of $6 million declined 40% year over year. Adjusted operating margin expanded 180 bps to 24% in the reported quarter.

BSX Shares 2026 and Q1 View

For 2026, Boston Scientific anticipates net sales to grow approximately 10.5-11.5% on a reported basis and 10-11% on an organic basis. The Zacks Consensus Estimate is currently pegged at $22.32 billion, indicating an 11.3% rise from the 2025 figure.

Full-year adjusted EPS is now expected in the range of $3.43-$3.49. The Zacks Consensus Estimate for the same is currently pegged at $3.45.

For the first quarter of 2026, revenue growth is projected in the range of approximately 10.5-12% on a reported basis (up 8.5-10% organically). Adjusted earnings are expected in the range of 78-80 cents per share.

The Zacks Consensus Estimate for first-quarter earnings and revenues is pegged at 79 cents per share and $5.20 billion, respectively.

Our View on BSX Stock

Boston Scientific’s fourth-quarter 2025 earnings beat the Zacks Consensus Estimate by a strong margin. Although revenues topped estimates too, it was by a close margin of 0.4%. The performance reflected the strength of the company’s product portfolio and the effectiveness of its highly engaged global team. The expansion of both margins in the quarter is encouraging. Additionally, the 2026 sales and EPS projections reflected growth over 2025.

In the fourth quarter, the company witnessed broad regulatory approvals, clinical milestones and U.S. launches across cardiology, vascular, oncology, pain, metabolic and urology franchises, including FDA and CE marks for PFA, IVL, Y-90, laser and ESG platforms. It advanced multiple global clinical trials, expanded payer coverage and announced strategic acquisitions of Penumbra, Valencia Technologies and Nalu Medical to strengthen its vascular and neuromodulation portfolio.

BSX's Zacks Rank and Other Key Picks

Boston Scientific currently carries a Zacks Rank #2 (Buy).

Some other top-ranked stocks from the broader medical space are National Vision (EYE - Free Report) , Veeva Systems (VEEV - Free Report) and Prestige Consumer Healthcare (PBH - Free Report) .

National Vision, currently carrying a Zacks Rank #2 (Buy), reported third-quarter 2025 adjusted EPS of 13 cents, which topped the Zacks Consensus Estimate by 8.3%. Revenues of $487.3 million beat the Zacks Consensus Estimate by 2.7%. You can see the complete list of today’s Zacks #1 Rank (Strong Buy) stocks here.

EYE’s earnings yield of 5.8% compares favorably with the industry’s 2.8% yield. The company beat on earnings in each of the trailing four quarters, with the average surprise being 2.75%.

Veeva Systems, carrying a Zacks Rank #2 at present, posted third-quarter fiscal 2026 adjusted EPS of $2.04, exceeding the Zacks Consensus Estimate by 4.62%. Revenues of $811.24 million topped the Zacks Consensus Estimate by 2.44%.

VEEV has an earnings yield of 3.6% compared with the industry’s yield of -1.7%. The company’s earnings outpaced estimates in each of the trailing four quarters, the average surprise being 8.18%.

Prestige Consumer Healthcare, carrying a Zacks Rank #2 at present, reported second-quarter fiscal 2026 EPS of $1.07, which surpassed the Zacks Consensus Estimate by 10.3%. Revenues of $274.1 million topped the Zacks Consensus Estimate by 6.9%.

PBH has an earnings yield of 7.1% compared with the industry’s 2.8% yield. The company’s earnings outperformed estimates in three of the trailing four quarters and missed in the other one, with the average surprise being 2.8%.

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