Despite reporting revenue of $20bn in its fiscal year 2025 (FY25) and strong growth in Q4 2025, Boston Scientific’s shares took a hit at market open after the release of its financials.
Boston released its year-end results ahead of market open on 4 February. The company’s shares on the Nasdaq stock exchange were trading at $81.38 at market open on 4 February, a 11% drop from a $91.62 per share close on 3 February. Share prices fell by a further 7.2% by market close on 4 February. Boston has a market cap around $111.9bn.
In Q4 2025, Boston achieved revenue of $5.2bn, indicative of a 15.9% uptick on Q4 2024. The majority of the quarter’s profits came via sales in Boston’s cardiovascular portfolio at $3.4bn, corresponding to an 18.2% rise on Q4 2024. Meanwhile, for FY25, cardiovascular contributed $13.3bn to the above $20bn total for the year, representing a growth margin of 23.2% versus $10.8bn for the vertical in FY24.
In spite of this performance, the market seemingly homed in on flat sales, relative to Q3 2025, in Boston’s electrophysiology (EP) and Watchman segments within its cardiovascular portfolio.
Boston’s EP segment, which includes its Farapulse pulsed-field ablation (PFA) system, drew in total global Q4 revenues of $890m, representing YoY growth of 37.1%. However, this figure was flat on a quarter-by-quarter basis, with Q3 2025’s sales totalling $865m. Electrophysiology systems, like Farapulse, are seen as a major growth driver for the company given the size of the atrial fibrillation market.
Meanwhile, Boston’s Watchman franchise achieved total Q4 sales of $535m.And while the total figure represents a 29.4% uplift on Q4 2024, it represents only a modest climb from $512m in total sales in Q3 2025. For both the EP and Watchman segments, the US was the largest market.
Looking ahead to 2026, Boston expects to achieve growth of in the 10.5% to 11.5% range, with earnings between $3.43 and $3.49 per share. The company outlined that in 2026, it expects 15% growth in the EP market.
During a conference call, analysts questioned what happened in Q4 vis-à-vis Boston’s expectations versus those of the market, highlighting investor concerns over flat EP and Watchman sales given they present two of Boston’s key growth drivers. With respect to the EP market, Mahoney commented that the company placed more conservative numbers on its overall growth in late 2025.
Boston CEO Mike Mahoney said: “We think the market in Q4 was closer to 18% to 20% growth rather than some other companies’ claim that it was 25%. We think the market was in the 18% to 20% range, similar to what we developed internally in our plan. We've called the market for 2026 at around 15% growth. We think it's an excellent market, but we don't think it grew 25% in the fourth quarter.”
Pressed further on Boston’s EP performance, Mahoney added that “some maybe overshot the market growth in Q4”.
Mahoney added: “We expect to lose some market share given competitor product launches that are coming out. However, we are also very comfortable to say that by the end of 2026, we will be the clear PFA market leader.”
Regarding Watchman, Mahoney said Boston was “quite proud” of the 29% growth [in the US] of the franchise.
“When you come to the consensus numbers, we exceeded our guidance, and actually exceeded analyst consensus,” he added.
Elsewhere across the business, Boston’s medsurg portfolio rose by 11.7% to $1.8bn in Q4. For FY25, the segment achieved revenue of $6.8bn, denoting a 13.9% rise on FY24.
Other large medtech players have begun posting their most recent financials. Releasing its latest financials on 4 February, GE HealthCare reported FY25 revenues of $20.6bn amid ongoing imaging demand and now expects earnings to fall in the $4.95 to $5.15 per share range for FY26.
