Boston Scientific (BSX)
Market Price (4/24/2026): $63.03 | Market Cap: $93.5 BilSector: Health Care | Industry: Health Care Equipment
Boston Scientific (BSX)
Market Price (4/24/2026): $63.03Market Cap: $93.5 BilSector: Health CareIndustry: Health Care Equipment
Investment Highlights Why It Matters Detailed financial logic regarding cash flow yields vs trend-riding momentum.
Attractive cash flow generationCFO/Rev LTMCash Flow from Operations / Revenue (Sales), Last Twelve Months (LTM) is 23%, FCF/Rev LTMFree Cash Flow / Revenue (Sales), Last Twelve Months (LTM) is 17%, CFO LTM is 4.5 Bil, FCF LTM is 3.4 Bil Valuation becoming less expensiveP/S 6M Chg %Price/Sales change over 6 months. Declining P/S indicates valuation has become less expensive. is -35% Low stock price volatilityVol 12M is 31% Megatrend and thematic driversMegatrends include Precision Medicine, Digital Health & Telemedicine, Aging Population & Chronic Disease, and Biotechnology & Genomics. Show more. | Weak multi-year price returns2Y Excs Rtn is -44%, 3Y Excs Rtn is -44% | Expensive valuation multiplesP/EBITPrice/EBIT or Price/(Operating Income) ratio is 26x, P/EPrice/Earnings or Price/(Net Income) is 34x Key risksBSX key risks include [1] significant financial and reputational damage from product liability lawsuits and settlements for alleged defects or failures, Show more. |
| Attractive cash flow generationCFO/Rev LTMCash Flow from Operations / Revenue (Sales), Last Twelve Months (LTM) is 23%, FCF/Rev LTMFree Cash Flow / Revenue (Sales), Last Twelve Months (LTM) is 17%, CFO LTM is 4.5 Bil, FCF LTM is 3.4 Bil |
| Valuation becoming less expensiveP/S 6M Chg %Price/Sales change over 6 months. Declining P/S indicates valuation has become less expensive. is -35% |
| Low stock price volatilityVol 12M is 31% |
| Megatrend and thematic driversMegatrends include Precision Medicine, Digital Health & Telemedicine, Aging Population & Chronic Disease, and Biotechnology & Genomics. Show more. |
| Weak multi-year price returns2Y Excs Rtn is -44%, 3Y Excs Rtn is -44% |
| Expensive valuation multiplesP/EBITPrice/EBIT or Price/(Operating Income) ratio is 26x, P/EPrice/Earnings or Price/(Net Income) is 34x |
| Key risksBSX key risks include [1] significant financial and reputational damage from product liability lawsuits and settlements for alleged defects or failures, Show more. |
Qualitative Assessment
AI Analysis | Feedback
1. Significantly lowered full-year 2026 guidance. Boston Scientific revised its full-year 2026 organic revenue growth outlook to 6.5%-8.0%, a reduction from prior expectations. Additionally, the adjusted EPS guidance for the full year was lowered to $3.34-$3.41, representing 9%-11% growth, falling below the consensus estimate of approximately $3.45 per share.
2. Unexpected headwinds in key growth businesses. The company cited unanticipated challenges in its Electrophysiology (EP), WATCHMAN, and Urology segments as primary drivers for the reduced outlook. Electrophysiology experienced increased competitive pressure and market share erosion, while U.S. WATCHMAN volumes declined starting in mid-February. The Urology segment's organic growth was only 1% due to difficulties in stone management and sacral neuromodulation.
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Stock Movement Drivers
Fundamental Drivers
The -31.1% change in BSX stock from 12/31/2025 to 4/23/2026 was primarily driven by a -33.6% change in the company's P/E Multiple.| (LTM values as of) | 12312025 | 4232026 | Change |
|---|---|---|---|
| Stock Price ($) | 95.35 | 65.69 | -31.1% |
| Change Contribution By: | |||
| Total Revenues ($ Mil) | 19,350 | 20,075 | 3.7% |
| Net Income Margin (%) | 14.4% | 14.4% | 0.0% |
| P/E Multiple | 50.6 | 33.6 | -33.6% |
| Shares Outstanding (Mil) | 1,482 | 1,483 | -0.1% |
| Cumulative Contribution | -31.1% |
Market Drivers
12/31/2025 to 4/23/2026| Return | Correlation | |
|---|---|---|
| BSX | -31.1% | |
| Market (SPY) | 4.2% | 11.1% |
| Sector (XLV) | -5.5% | 2.4% |
Fundamental Drivers
The -32.7% change in BSX stock from 9/30/2025 to 4/23/2026 was primarily driven by a -41.7% change in the company's P/E Multiple.| (LTM values as of) | 9302025 | 4232026 | Change |
|---|---|---|---|
| Stock Price ($) | 97.63 | 65.69 | -32.7% |
| Change Contribution By: | |||
| Total Revenues ($ Mil) | 18,494 | 20,075 | 8.5% |
| Net Income Margin (%) | 13.5% | 14.4% | 6.6% |
| P/E Multiple | 57.7 | 33.6 | -41.7% |
| Shares Outstanding (Mil) | 1,480 | 1,483 | -0.2% |
| Cumulative Contribution | -32.7% |
Market Drivers
9/30/2025 to 4/23/2026| Return | Correlation | |
|---|---|---|
| BSX | -32.7% | |
| Market (SPY) | 7.0% | 11.9% |
| Sector (XLV) | 5.5% | 12.2% |
Fundamental Drivers
The -34.9% change in BSX stock from 3/31/2025 to 4/23/2026 was primarily driven by a -58.1% change in the company's P/E Multiple.| (LTM values as of) | 3312025 | 4232026 | Change |
|---|---|---|---|
| Stock Price ($) | 100.88 | 65.69 | -34.9% |
| Change Contribution By: | |||
| Total Revenues ($ Mil) | 16,746 | 20,075 | 19.9% |
| Net Income Margin (%) | 11.1% | 14.4% | 30.5% |
| P/E Multiple | 80.3 | 33.6 | -58.1% |
| Shares Outstanding (Mil) | 1,474 | 1,483 | -0.6% |
| Cumulative Contribution | -34.9% |
Market Drivers
3/31/2025 to 4/23/2026| Return | Correlation | |
|---|---|---|
| BSX | -34.9% | |
| Market (SPY) | 28.1% | 34.7% |
| Sector (XLV) | 1.5% | 30.2% |
Fundamental Drivers
The 31.3% change in BSX stock from 3/31/2023 to 4/23/2026 was primarily driven by a 162.3% change in the company's Net Income Margin (%).| (LTM values as of) | 3312023 | 4232026 | Change |
|---|---|---|---|
| Stock Price ($) | 50.03 | 65.69 | 31.3% |
| Change Contribution By: | |||
| Total Revenues ($ Mil) | 12,682 | 20,075 | 58.3% |
| Net Income Margin (%) | 5.5% | 14.4% | 162.3% |
| P/E Multiple | 102.7 | 33.6 | -67.3% |
| Shares Outstanding (Mil) | 1,433 | 1,483 | -3.4% |
| Cumulative Contribution | 31.3% |
Market Drivers
3/31/2023 to 4/23/2026| Return | Correlation | |
|---|---|---|
| BSX | 31.3% | |
| Market (SPY) | 79.8% | 35.7% |
| Sector (XLV) | 18.3% | 34.7% |
Price Returns Compared
| 2021 | 2022 | 2023 | 2024 | 2025 | 2026 | Total [1] | |
|---|---|---|---|---|---|---|---|
| Returns | |||||||
| BSX Return | 18% | 9% | 25% | 55% | 7% | -32% | 80% |
| Peers Return | 9% | -8% | 5% | 3% | 14% | -6% | 16% |
| S&P 500 Return | 27% | -19% | 24% | 23% | 16% | 4% | 90% |
Monthly Win Rates [3] | |||||||
| BSX Win Rate | 42% | 58% | 58% | 83% | 67% | 25% | |
| Peers Win Rate | 55% | 50% | 52% | 50% | 60% | 45% | |
| S&P 500 Win Rate | 75% | 42% | 67% | 75% | 67% | 50% | |
Max Drawdowns [4] | |||||||
| BSX Max Drawdown | -2% | -17% | -3% | -0% | 0% | -38% | |
| Peers Max Drawdown | -7% | -20% | -10% | -6% | -7% | -10% | |
| S&P 500 Max Drawdown | -1% | -25% | -1% | -2% | -15% | -7% | |
[1] Cumulative total returns since the beginning of 2021
[2] Peers: MDT, ABT, JNJ, SYK, BDX. See BSX Returns vs. Peers.
[3] Win Rate = % of calendar months in which monthly returns were positive
[4] Max drawdown represents maximum peak-to-trough decline within a year
[5] 2026 data is for the year up to 4/23/2026 (YTD)
How Low Can It Go
| Event | BSX | S&P 500 |
|---|---|---|
| 2022 Inflation Shock | ||
| % Loss | -25.2% | -25.4% |
| % Gain to Breakeven | 33.7% | 34.1% |
| Time to Breakeven | 181 days | 464 days |
| 2020 Covid Pandemic | ||
| % Loss | -43.5% | -33.9% |
| % Gain to Breakeven | 77.0% | 51.3% |
| Time to Breakeven | 497 days | 148 days |
| 2018 Correction | ||
| % Loss | -18.7% | -19.8% |
| % Gain to Breakeven | 23.0% | 24.7% |
| Time to Breakeven | 46 days | 120 days |
| 2008 Global Financial Crisis | ||
| % Loss | -70.5% | -56.8% |
| % Gain to Breakeven | 239.2% | 131.3% |
| Time to Breakeven | 2,538 days | 1,480 days |
Compare to MDT, ABT, JNJ, SYK, BDX
In The Past
Boston Scientific's stock fell -25.2% during the 2022 Inflation Shock from a high on 4/20/2022. A -25.2% loss requires a 33.7% gain to breakeven.
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About Boston Scientific (BSX)
AI Analysis | Feedback
1. Essentially a Medtronic-like company, specializing in a wide range of interventional medical devices.
2. Like the medical device arm of Johnson & Johnson, but purely focused on interventional technologies.
AI Analysis | Feedback
Boston Scientific (BSX) develops, manufactures, and markets medical devices across various interventional specialties. Its major products include:
- Gastrointestinal and Pulmonary Devices: Medical devices for diagnosing and treating conditions of the digestive system and lungs.
- Urological and Pelvic Health Devices: Devices designed to treat various conditions affecting the urinary system and pelvic organs.
- Cardiac Rhythm Management Devices: Implantable devices like defibrillators and pacemakers, along with remote monitoring systems, to manage heart rate and rhythm disorders.
- Electrophysiology Technologies: Advanced tools including mapping and ablation catheters used to diagnose and treat complex heart rhythm disorders.
- Neuromodulation Systems: Devices such as spinal cord and deep brain stimulators for managing chronic pain and neurological conditions.
- Interventional Cardiology Products: A range of devices including drug-eluting stents, PCI products, imaging catheters, and structural heart therapies for treating coronary and structural heart diseases.
- Peripheral Interventions Products: Devices like stents, balloons, and atherectomy systems used to treat arterial, venous, and other peripheral vascular diseases, including cancer therapies.
AI Analysis | Feedback
Boston Scientific (BSX) sells its medical devices primarily to healthcare institutions and organizations worldwide. Due to the fragmented nature of the global healthcare market and the extensive range of Boston Scientific's product portfolio, they do not typically have a few named public companies that constitute "major customers" in the traditional sense. Instead, their customer base is broadly categorized as follows:
- Hospitals and Health Systems: These institutions are the primary purchasers and end-users for a vast array of Boston Scientific's medical devices, utilized in various interventional specialties such as cardiology, gastroenterology, urology, and neurology. This category includes academic medical centers, community hospitals, and integrated delivery networks globally.
- Ambulatory Surgical Centers (ASCs) and Specialty Clinics: For less invasive and outpatient procedures, ambulatory surgical centers and specialized clinics (e.g., cardiology clinics, endoscopy centers, pain management clinics) represent a significant and growing customer segment for many of Boston Scientific's devices.
- Group Purchasing Organizations (GPOs) and Distributors: While not direct end-users of the medical devices, GPOs play a critical role by negotiating purchasing contracts on behalf of their member hospitals and health systems, effectively channeling sales. Distributors manage the logistics of product delivery to healthcare providers. Both are crucial intermediaries and major partners in Boston Scientific's sales and supply chain strategy.
AI Analysis | Feedback
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Michael F. Mahoney - Chairman and Chief Executive Officer
Michael F. Mahoney is the Chairman and Chief Executive Officer of Boston Scientific Corporation. He joined Boston Scientific as President in October 2011, became CEO in November 2012, and assumed the role of Chairman in 2016. Prior to his tenure at Boston Scientific, Mahoney served as Worldwide Chairman of the Medical Devices and Diagnostics division of Johnson & Johnson. From 2001 to 2006, he was President and Chief Executive Officer of Global Healthcare Exchange (GHX), a company he built through organic development and strategic acquisitions, integrating seven acquisitions and expanding its operations into Europe and Canada. He began his career at General Electric Medical Systems, where he spent twelve years in various leadership roles within diagnostic imaging, cardiology, and healthcare information technology.
Jon Monson - Executive Vice President and Chief Financial Officer
Jon Monson serves as the Executive Vice President and Chief Financial Officer of Boston Scientific, a position he assumed effective June 30, 2025. He has been with Boston Scientific for over 25 years, holding various roles of increasing responsibility within the finance organization. His previous positions include Senior Vice President, Investor Relations, Global Controller, Chief Accounting Officer, and Vice President and Controller of the company's Urology business. Monson is a certified public accountant and holds a bachelor's degree in economics and accounting from the College of the Holy Cross.
Arthur C. Butcher - Executive Vice President and Group President, MedSurg and Asia Pacific
Arthur C. Butcher is the Executive Vice President and Group President for MedSurg and Asia Pacific at Boston Scientific. He has previously served as Senior Vice President and President of Endoscopy for the company.
Joseph M. Fitzgerald - Executive Vice President and Group President, Cardiology
Joseph M. Fitzgerald holds the position of Executive Vice President and Group President, Cardiology at Boston Scientific. He is responsible for the company's cardiology-related businesses.
Vance R. Brown - Executive Vice President, General Counsel and Corporate Secretary
Vance R. Brown is the Executive Vice President, General Counsel and Corporate Secretary at Boston Scientific. In this role, he oversees the company's legal affairs and corporate governance.
AI Analysis | Feedback
The key risks to Boston Scientific's business operations and financial performance are primarily centered around its regulatory and legal environment, intense market competition, and the inherent product liability associated with medical devices.
- Legal and Regulatory Risks: Boston Scientific faces significant exposure to legal and regulatory challenges, which are frequently cited as the top risk category for the company. The company is currently dealing with multiple class-action lawsuits and a federal probe related to the AXIOS stent recall and disclosure allegations, which could result in substantial settlements, fines, and reputational damage. In the past, Boston Scientific has incurred billions in litigation-related charges, particularly from transvaginal mesh product liability cases. Recent Class I recalls, which indicate a high probability of serious adverse health consequences or death, have been issued for products such as the AXIOS Stent & Delivery System and certain pacemakers due to manufacturing flaws. Additionally, FDA safety alerts have been issued for Endotak Reliance defibrillator wires and Watchman implants due to reported injuries and deaths. Changes in healthcare regulations, reimbursement policies, and the evolving ethical and regulatory landscape of medical AI also present ongoing risks.
- Competition and Technological Obsolescence: The medical device industry is highly competitive and technology-driven, requiring continuous innovation. Boston Scientific faces intense competition from established rivals and new market entrants, particularly in key segments like electrophysiology, where competitive pressures are reportedly increasing and impacting market share. There is a constant risk that competitors will introduce more effective, advanced, or cheaper products, or that Boston Scientific's own products may become technologically obsolete. The company has also experienced setbacks, such as disappointing clinical results in the transcatheter heart valve space, which can diminish opportunities in important growth markets. Maintaining momentum and market leadership requires sustained investment in research and development and successful clinical outcomes for new products.
AI Analysis | Feedback
The rise of gene therapy and other advanced precision medicine approaches that aim to cure or prevent diseases at a genetic or cellular level represents a clear emerging threat. Many of Boston Scientific's devices address the symptoms or mechanical issues of chronic conditions (e.g., cardiovascular disease, chronic pain, certain cancers, neurological disorders). If these underlying diseases can be effectively treated or prevented through targeted biological interventions, the demand for device-based therapies could significantly diminish.
AI Analysis | Feedback
Boston Scientific Corporation (BSX) operates in several large and growing addressable markets for its medical devices across its MedSurg, Rhythm and Neuro, and Cardiovascular segments.
Cardiovascular Segment
- Structural Heart Devices: The global structural heart devices market was estimated at approximately USD 16.13 billion in 2024 and is projected to reach USD 50.99 billion by 2033. North America accounted for the largest revenue share in 2024.
- Interventional Cardiology Devices: The global interventional cardiology devices market was valued at approximately USD 29.41 billion in 2025 and is projected to reach USD 42.39 billion by 2031. North America held the largest global revenue share in 2025.
- Peripheral Vascular Devices: The global peripheral vascular device market was valued at approximately USD 10.67 billion in 2024 and is projected to grow to USD 18.51 billion by 2034. North America led the global market with a 40.8% market share in 2024. The broader global interventional cardiology and peripheral vascular devices market was valued at USD 27.7 billion in 2025 and is projected to reach USD 60.8 billion by 2035.
Rhythm and Neuro Segment
- Cardiac Rhythm Management Devices: The global cardiac rhythm management devices market was valued at approximately USD 23.5 billion in 2024 and is expected to grow to USD 39.7 billion by 2034. The U.S. cardiac rhythm management devices market accounted for USD 11.1 billion in 2024. North America dominated the global market in 2024.
- Spinal Cord Stimulators: The global spinal cord stimulator market is expected to increase from approximately USD 3,437 million in 2024 to USD 7,243.98 million by 2032. North America is the largest market for spinal cord stimulators.
- Deep Brain Stimulation Systems: The global deep brain stimulation devices market was estimated at approximately USD 1.54 billion in 2025 and is expected to reach USD 4.43 billion by 2035. North America captured approximately 41.88% of the market share in 2025.
MedSurg Segment
- Gastrointestinal Devices: The global gastrointestinal devices market was estimated at USD 11.11 billion in 2024, growing to USD 11.79 billion in 2025, and is projected to reach USD 16.38 billion in 2029. North America commanded 39.62% of revenue in 2025.
- Urology and Pelvic Health Devices: The global urology devices market was estimated at USD 36.8 billion in 2024 and is expected to grow to USD 73.5 billion in 2034. North America currently holds the largest share of the global urology devices market.
AI Analysis | Feedback
Expected Drivers of Future Revenue Growth for Boston Scientific (BSX)
Over the next 2-3 years, Boston Scientific (BSX) is expected to drive future revenue growth through several key strategic areas and product innovations:
- Electrophysiology (EP) Innovations: The company anticipates significant growth from its Electrophysiology portfolio, particularly with the continued adoption of its FARAPULSE pulsed-field ablation (PFA) system. Strong market demand for PFA technology and the planned launch of next-generation devices like FARAPULSE Ultra are expected to fuel this segment's expansion. The global PFA market is projected to experience substantial growth.
- Structural Heart Therapies (WATCHMAN): Continued strong adoption of the WATCHMAN FLX Pro device for left atrial appendage closure (LAAC) is a key growth driver. The potential impact of ongoing clinical trials, such as the CHAMPION-AF trial, could further enhance the WATCHMAN business.
- Interventional Cardiology & Vascular Therapies (ICVT): Boston Scientific expects robust sales growth within its Interventional Cardiology and Vascular Therapies segments. The company's strategy in capturing market share, capitalizing on recent acquisitions, and launching new products like Seismic IVL contributes to this growth.
- Strategic Acquisitions: Acquisitions are a crucial component of Boston Scientific's growth strategy. Recent and planned acquisitions, such as Valencia Technologies Corporation and Penumbra, are anticipated to expand capabilities in areas like neurovascular and thrombectomy, thereby contributing to overall revenue growth.
- MedSurg Segment Growth (Urology and Neuromodulation): The company's diverse MedSurg product lines, specifically urology and neuromodulation, are demonstrating strong market demand and are expected to continue their growth trajectory through successful product launches and market penetration.
AI Analysis | Feedback
Share Repurchases
- Boston Scientific expanded its stock repurchase program by an additional $4 billion, increasing the total authorization to $5 billion, effective February 18, 2026. All authorized funds are currently available for use.
Share Issuance
- In 2025, Boston Scientific received $282 million from stock issuances related to employee stock plans.
Outbound Investments
- Boston Scientific has pursued a strategy of acquisitions to strengthen its core businesses and expand into high-growth adjacent markets. Acquisitions contributed 420 basis points to sales in the third quarter of 2025, resulting in 15.3% organic revenue growth.
- Key acquisitions include the agreement to acquire Penumbra in January 2026 for $14.5 billion, which is expected to expand capabilities in neurovascular and thrombectomy, and Valencia Technologies Corporation in January 2026 to enhance urology offerings.
- Other significant acquisitions in the last 3-5 years include Axonics, Inc. for $3.7 billion in November 2024, Silk Road Medical, Inc. for $1.16 billion in June 2024, Relievant Medsystems, Inc. for $850 million in November 2023, and Baylis Medical for $1.75 billion in October 2021.
Capital Expenditures
- Capital expenditures are projected to increase from 4.7% of revenue in 2024 to 7% of revenue by 2030, aimed at maintaining high-growth rates, increasing production capabilities, and investing in new projects.
- The company is making substantial investments in its supply chain and manufacturing infrastructure, including expanding its manufacturing footprint in China, Costa Rica, and Malaysia, and integrating AI and automation into its manufacturing network.
Latest Trefis Analyses
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| Date | Ticker | Company | Category | Trade Strategy | 6M Fwd Rtn | 12M Fwd Rtn | 12M Max DD |
|---|---|---|---|---|---|---|---|
| 03312026 | PGNY | Progyny | Dip Buy | DB | FCF Yield | Low D/EDip Buy with High Free Cash Flow YieldBuying dips for companies with significant free cash flow yield (FCF / Market Cap) and reasonable debt / market cap | 0.0% | 0.0% | 0.0% |
| 03272026 | CNC | Centene | Dip Buy | DB | FCF Yield | Low D/EDip Buy with High Free Cash Flow YieldBuying dips for companies with significant free cash flow yield (FCF / Market Cap) and reasonable debt / market cap | 2.3% | 2.3% | -0.6% |
| 03272026 | OSCR | Oscar Health | Dip Buy | DB | FCF Yield | Low D/EDip Buy with High Free Cash Flow YieldBuying dips for companies with significant free cash flow yield (FCF / Market Cap) and reasonable debt / market cap | 3.0% | 3.0% | -2.6% |
| 03202026 | WAT | Waters | Monopoly | MY | Getting CheaperMonopoly-Like with P/S DeclineLarge cap with monopoly-like margins or cash flow generation and getting cheaper based on P/S multiple | -0.4% | -0.4% | -3.3% |
| 03202026 | GILD | Gilead Sciences | Quality | Q | Momentum | UpsideQuality Stocks with Momentum and UpsideBuying quality stocks with strong momentum but still having room to run | 1.6% | 1.6% | -2.2% |
Research & Analysis
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Peer Comparisons
| Peers to compare with: |
Financials
| Median | |
|---|---|
| Name | |
| Mkt Price | 123.66 |
| Mkt Cap | 116.8 |
| Rev LTM | 30,300 |
| Op Inc LTM | 5,835 |
| FCF LTM | 4,846 |
| FCF 3Y Avg | 4,452 |
| CFO LTM | 6,164 |
| CFO 3Y Avg | 5,674 |
Growth & Margins
| Median | |
|---|---|
| Name | |
| Rev Chg LTM | 7.4% |
| Rev Chg 3Y Avg | 5.1% |
| Rev Chg Q | 9.3% |
| QoQ Delta Rev Chg LTM | 2.2% |
| Op Inc Chg LTM | 14.5% |
| Op Inc Chg 3Y Avg | 7.8% |
| Op Mgn LTM | 19.2% |
| Op Mgn 3Y Avg | 18.4% |
| QoQ Delta Op Mgn LTM | 0.5% |
| CFO/Rev LTM | 21.1% |
| CFO/Rev 3Y Avg | 20.1% |
| FCF/Rev LTM | 16.8% |
| FCF/Rev 3Y Avg | 15.2% |
Valuation
| Median | |
|---|---|
| Name | |
| Mkt Cap | 116.8 |
| P/S | 4.2 |
| P/Op Inc | 20.8 |
| P/EBIT | 19.7 |
| P/E | 25.8 |
| P/CFO | 19.1 |
| Total Yield | 6.3% |
| Dividend Yield | 2.4% |
| FCF Yield 3Y Avg | 3.6% |
| D/E | 0.1 |
| Net D/E | 0.1 |
Returns
| Median | |
|---|---|
| Name | |
| 1M Rtn | -2.6% |
| 3M Rtn | -11.1% |
| 6M Rtn | -11.6% |
| 12M Rtn | -3.6% |
| 3Y Rtn | 7.7% |
| 1M Excs Rtn | -11.0% |
| 3M Excs Rtn | -13.9% |
| 6M Excs Rtn | -17.5% |
| 12M Excs Rtn | -36.2% |
| 3Y Excs Rtn | -56.2% |
Comparison Analyses
Segment Financials
Assets by Segment| $ Mil | 2025 | 2024 | 2023 | 2022 | 2021 |
|---|---|---|---|---|---|
| Goodwill | 17,089 | 14,387 | 12,920 | 11,988 | 9,951 |
| Cardiovascular | 7,084 | 5,988 | 5,205 | 4,417 | 2,461 |
| Other intangible assets, net | 6,684 | 6,003 | 5,902 | 6,121 | 5,917 |
| All other corporate assets | 5,446 | 5,869 | 5,941 | 7,525 | 7,850 |
| MedSurg | 3,093 | 2,888 | 2,501 | 2,178 | 1,638 |
| Other | 1,133 | ||||
| Rhythm and Neuro | 1,827 | ||||
| Total | 39,396 | 35,135 | 32,469 | 32,229 | 30,777 |
Price Behavior
| Market Price | $65.69 | |
| Market Cap ($ Bil) | 97.4 | |
| First Trading Date | 05/19/1992 | |
| Distance from 52W High | -39.3% | |
| 50 Days | 200 Days | |
| DMA Price | $68.92 | $91.34 |
| DMA Trend | down | down |
| Distance from DMA | -4.7% | -28.1% |
| 3M | 1YR | |
| Volatility | 50.4% | 30.8% |
| Downside Capture | 199.42 | 101.76 |
| Upside Capture | 37.92 | 21.91 |
| Correlation (SPY) | 15.6% | 16.6% |
| 1M | 2M | 3M | 6M | 1Y | 3Y | |
|---|---|---|---|---|---|---|
| Beta | 0.32 | -0.06 | -0.11 | 0.13 | 0.58 | 0.57 |
| Up Beta | -0.08 | -1.11 | -0.43 | 0.39 | 0.67 | 0.67 |
| Down Beta | -0.50 | -1.02 | -1.08 | -0.54 | 0.54 | 0.67 |
| Up Capture | 68% | -29% | -28% | -4% | 17% | 20% |
| Bmk +ve Days | 7 | 16 | 27 | 65 | 139 | 424 |
| Stock +ve Days | 9 | 18 | 28 | 61 | 121 | 404 |
| Down Capture | 114% | 133% | 117% | 82% | 81% | 69% |
| Bmk -ve Days | 12 | 23 | 33 | 58 | 110 | 323 |
| Stock -ve Days | 13 | 24 | 35 | 65 | 128 | 344 |
[1] Upside and downside betas calculated using positive and negative benchmark daily returns respectively
Based On 1-Year Data
| Annualized Return | Annualized Volatility | Sharpe Ratio | Correlation with BSX | |
|---|---|---|---|---|
| BSX | -31.1% | 31.0% | -1.18 | - |
| Sector ETF (XLV) | 9.8% | 15.8% | 0.40 | 17.4% |
| Equity (SPY) | 36.1% | 12.7% | 2.15 | 16.9% |
| Gold (GLD) | 38.7% | 27.3% | 1.18 | 1.4% |
| Commodities (DBC) | 45.3% | 18.0% | 1.93 | -8.1% |
| Real Estate (VNQ) | 14.6% | 13.3% | 0.77 | 5.5% |
| Bitcoin (BTCUSD) | -16.3% | 42.1% | -0.31 | -1.4% |
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Based On 5-Year Data
| Annualized Return | Annualized Volatility | Sharpe Ratio | Correlation with BSX | |
|---|---|---|---|---|
| BSX | 9.9% | 24.7% | 0.37 | - |
| Sector ETF (XLV) | 5.4% | 14.6% | 0.19 | 47.7% |
| Equity (SPY) | 12.6% | 17.1% | 0.58 | 47.8% |
| Gold (GLD) | 21.0% | 17.8% | 0.96 | 7.7% |
| Commodities (DBC) | 14.5% | 19.1% | 0.62 | 6.4% |
| Real Estate (VNQ) | 3.7% | 18.8% | 0.10 | 37.4% |
| Bitcoin (BTCUSD) | 4.9% | 56.4% | 0.31 | 16.1% |
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Based On 10-Year Data
| Annualized Return | Annualized Volatility | Sharpe Ratio | Correlation with BSX | |
|---|---|---|---|---|
| BSX | 12.9% | 27.0% | 0.48 | - |
| Sector ETF (XLV) | 9.5% | 16.5% | 0.46 | 59.9% |
| Equity (SPY) | 14.9% | 17.9% | 0.71 | 59.3% |
| Gold (GLD) | 13.9% | 15.9% | 0.73 | 4.1% |
| Commodities (DBC) | 10.0% | 17.8% | 0.47 | 18.7% |
| Real Estate (VNQ) | 5.5% | 20.7% | 0.23 | 49.6% |
| Bitcoin (BTCUSD) | 68.5% | 66.9% | 1.08 | 11.7% |
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Returns Analyses
Earnings Returns History
Expand for More| Forward Returns | |||
|---|---|---|---|
| Earnings Date | 1D Returns | 5D Returns | 21D Returns |
| 4/22/2026 | 9.0% | ||
| 2/4/2026 | -17.6% | -19.0% | -20.3% |
| 10/22/2025 | 4.0% | 1.1% | -2.9% |
| 7/23/2025 | 4.5% | 3.2% | 2.8% |
| 4/23/2025 | 4.1% | 8.1% | 10.1% |
| 2/5/2025 | 1.4% | 2.4% | -2.6% |
| 10/23/2024 | -0.6% | -3.9% | 2.5% |
| 7/24/2024 | -1.1% | -5.8% | 0.3% |
| ... | |||
| SUMMARY STATS | |||
| # Positive | 15 | 14 | 15 |
| # Negative | 9 | 9 | 8 |
| Median Positive | 4.0% | 3.5% | 2.8% |
| Median Negative | -1.3% | -2.9% | -4.8% |
| Max Positive | 9.0% | 9.2% | 11.3% |
| Max Negative | -17.6% | -19.0% | -20.3% |
SEC Filings
Expand for More| Report Date | Filing Date | Filing |
|---|---|---|
| 12/31/2025 | 02/17/2026 | 10-K |
| 09/30/2025 | 11/03/2025 | 10-Q |
| 06/30/2025 | 08/01/2025 | 10-Q |
| 03/31/2025 | 05/01/2025 | 10-Q |
| 12/31/2024 | 02/18/2025 | 10-K |
| 09/30/2024 | 11/01/2024 | 10-Q |
| 06/30/2024 | 08/01/2024 | 10-Q |
| 03/31/2024 | 05/01/2024 | 10-Q |
| 12/31/2023 | 02/20/2024 | 10-K |
| 09/30/2023 | 11/01/2023 | 10-Q |
| 06/30/2023 | 08/03/2023 | 10-Q |
| 03/31/2023 | 05/04/2023 | 10-Q |
| 12/31/2022 | 02/23/2023 | 10-K |
| 09/30/2022 | 11/03/2022 | 10-Q |
| 06/30/2022 | 08/04/2022 | 10-Q |
| 03/31/2022 | 05/05/2022 | 10-Q |
Recent Forward Guidance [BETA]
Latest: Q1 2026 Earnings Reported 4/22/2026
| Forward Guidance | Guidance Change | ||||||
|---|---|---|---|---|---|---|---|
| Metric | Low | Mid | High | % Chg | % Delta | Change | Prior |
| Q2 2026 Revenue Growth | 5.5% | 6.5% | 7.5% | ||||
| Q2 2026 Organic Revenue Growth | 5.0% | 6.0% | 7.0% | ||||
| Q2 2026 EPS | 0.82 | 0.83 | 0.84 | ||||
| 2026 Revenue Growth | 7.0% | 7.75% | 8.5% | -29.5% | -3.2% | Lowered | Guidance: 11.0% for 2026 |
| 2026 Organic Revenue Growth | 6.5% | 7.25% | 8.0% | -31.0% | -3.2% | Lowered | Guidance: 10.5% for 2026 |
| 2026 EPS | 3.34 | 3.38 | 3.41 | -2.5% | Lowered | Guidance: 3.46 for 2026 | |
Prior: Q4 2025 Earnings Reported 2/4/2026
| Forward Guidance | Guidance Change | ||||||
|---|---|---|---|---|---|---|---|
| Metric | Low | Mid | High | % Chg | % Delta | Change | Prior |
| Q1 2026 Net Sales Growth (Reported) | 10.5% | 11.25% | 12.0% | -27.4% | -4.2% | Lowered | Actual: 15.5% for Q4 2025 |
| Q1 2026 Net Sales Growth (Organic) | 8.5% | 9.25% | 10.0% | -22.9% | -2.8% | Lowered | Actual: 12.0% for Q4 2025 |
| Q1 2026 Adjusted EPS | 0.78 | 0.79 | 0.8 | 1.3% | Raised | Actual: 0.78 for Q4 2025 | |
| 2026 Net Sales Growth (Reported) | 10.5% | 11.0% | 11.5% | -45.0% | -9.0% | Lowered | Actual: 20.0% for 2025 |
| 2026 Net Sales Growth (Organic) | 10.0% | 10.5% | 11.0% | -32.3% | -5.0% | Lowered | Actual: 15.5% for 2025 |
| 2026 Adjusted EPS | 3.43 | 3.46 | 3.49 | 14.2% | Raised | Actual: 3.03 for 2025 | |
BSX Trade Sentinel
AVOID (Score 1-2)
CONVICTION RATIONALE
The stock receives an AVOID (Score 1-2) rating. The investment thesis is breaking in real-time. The competitive moat in the most critical growth segment (Electrophysiology) is eroding, forcing a significant downward revision to guidance. The current valuation is speculative and does not reflect the new reality of slower growth and intense competition. The risk/reward is negatively skewed, with significant downside potential from multiple compression if the company fails to stabilize its market position.
STOCK ARCHETYPE
Quality Compounder / Stalwart (Primary) | Transition / Profit Pivot (Secondary)BSX is a 'Quality Compounder' due to its established leadership in cardiovascular devices, strong ROIC, and high switching costs. However, the current thesis hinges on a pivot from a diversified MedTech to a high-growth cardiovascular powerhouse, with success dependent on margin expansion and FCF generation from new products, which introduces a 'Transition / Profit Pivot' element.
INVESTMENT THESIS
The investment thesis is that BSX is successfully transitioning into a high-growth cardiovascular pure-play, away from its slower-growth MedSurg businesses. The rapid adoption of the FARAPULSE PFA system and continued penetration of the WATCHMAN device are expected to drive sustained double-digit growth in the high-margin Cardiovascular segment, leading to overall corporate margin expansion and a valuation re-rating.
- The Cardiovascular segment's revenue share grew to ~67% of total sales in the most recent period.
- Q1 2026 Cardiovascular organic growth was 11.2%, significantly outpacing the MedSurg segment's 5.7% growth.
- The Pulsed Field Ablation (PFA) market, where FARAPULSE competes, is projected to grow at a CAGR of 33.2% to $1.6 billion in 2026.
- Management targets ~50 basis points of annual adjusted operating margin expansion, driven by this favorable mix shift.
PRIMARY RISK
The primary risk is the rapid and severe erosion of market share in the critical Pulsed Field Ablation (PFA) market. Competitors Medtronic (PulseSelect) and Johnson & Johnson (Varipulse) are proving more effective at capturing share than anticipated, breaking the 'best-in-class' growth narrative. This is compounded by a simultaneous slowdown in the WATCHMAN franchise.
- Management explicitly cited 'greater-than-expected market share loss' in Electrophysiology for the guidance cut.
- Full-year 2026 organic growth guidance was slashed from a 10-11% range down to 6.5-8.0%.
- An industry leader was quoted stating his lab would shift from 100% BSX Farapulse to only 30%, with 70% going to Medtronic and J&J.
- J&J holds a key competitive advantage with its Varipulse system's integration into the dominant, pre-existing CARTO mapping platform, creating high switching costs for BSX to overcome.
| KPI | Threshold | Rationale |
|---|---|---|
| Full Year 2026 Organic Revenue Growth | Must stay within 6.5% - 8.0% range | This is the most critical metric. Any further reduction would confirm the bear case that competitive pressures are worsening and the growth story is broken. |
| Cardiovascular Segment Organic Growth | >9% | This segment is the entire long thesis. If its growth falls into the high-single-digits, it signals that the high-growth product cycle (Farapulse/WATCHMAN) is over or failing, eliminating the justification for a premium valuation. |
| Competitor EP/PFA Commentary | Monitor MDT/JNJ earnings for PFA sales figures/commentary | Quantitative reports from competitors on their PFA system sales will serve as a direct, external validation (or invalidation) of BSX's market share trajectory, acting as a leading indicator ahead of BSX's own reports. |
FARAPULSE: Growth Engine or Competitive Casualty?
BULL VIEW
The Q1 revenue beat shows underlying procedural strength. The guidance cut is a conservative reset, and FARAPULSE's superior clinical performance will ultimately win share.
CORE TENSION
Bulls see the recent guide-down as a temporary setback in the PFA market transition. Bears believe it signals permanent market share loss to better-integrated competitors.
PREVAILING SENTIMENT
Full-year 2026 organic growth guidance was slashed from a 10-11% range down to 6.5-8.0%, directly attributed to 'greater-than-expected market share loss' in Electrophysiology.
BEAR VIEW
Competitors Medtronic and J&J are rapidly eroding BSX's first-mover advantage. The severe guidance cut is mathematical proof the high-growth cardiovascular thesis is broken.
| Timeline | Event & Metric To Watch |
|---|---|
Late July 2026 | Q2 2026 Earnings & Guidance Update Watch: FY2026 Organic Growth Guidance. Watch if it holds the 6.5-8.0% range set in April, or is cut further, signaling deeper share loss. |
August 28-31, 2026 | ESC Congress 2026 Watch: Competitor PFA Data. Watch for late-breaking trial results from Medtronic or J&J showing superior efficacy or safety vs FARAPULSE. |
Late October 2026 | Q3 2026 Earnings Call Watch: Cardiovascular Segment Organic Growth. Needs to stay above 9% to support the premium valuation; Q1 was 11.2%. |
Next 6 Months | Securities Litigation Update Watch: Headline regarding court's decision on a motion to dismiss or news of a potential settlement. |
| Date | Event | Stock Impact |
|---|---|---|
Oct 22, 2025 | Q3 2025 Earnings Details: Boston Scientific reported strong Q3 results, with robust growth in the Cardiovascular segment, reinforcing the mix-shift narrative and driving the stock higher. | Rose significantly by 4.0% $99.90 -> $103.85 |
Nov 25, 2025 | Positive Sell-Side Research Details: The stock gained following positive analyst commentary regarding the long-term potential of the FARAPULSE and WATCHMAN franchises ahead of year-end. | Rose significantly by 3.4% $98.04 -> $101.36 |
Jan 16, 2026 | Broad MedTech Sector Weakness Details: The stock fell amid a broader market downturn for medical technology companies, likely driven by reimbursement concerns or macroeconomic fears, not company-specific news. | Fell notably by -2.2% $90.03 -> $88.07 |
Feb 4, 2026 | Q4 2025 Earnings & Disappointing Guidance Details: Stock plummeted after company reported disappointing U.S. Electrophysiology sales and issued initial FY26 guidance below expectations, citing intense competition. | Crashed -17.6% $91.62 -> $75.50 |
Mar 30, 2026 | Securities Fraud Lawsuit Filing Details: A class-action lawsuit was filed alleging misleading statements about the Electrophysiology business, causing significant stock decline as the news was digested. | Plummeted -9.0% $69.17 -> $62.93 |
Apr 22, 2026 | Q1 2026 Earnings & Guidance Cut Details: Despite a severe cut to FY26 guidance (10-11% to 6.5-8.0%), the stock rallied. Q1 organic revenue grew 9.4%, beating lowered expectations. | Surged +9.0% $59.52 -> $64.87 |
Position Sizing
1% - 3%
CONSERVATIVE
Stock is in an Explosive Volatility regime (3.3x S&P) with Spiking near-term fear. The Bearish sentiment, Eroding Moat, and speculative valuation demand a Conservative sizing to manage drawdown risk until visibility improves.
Diversification Alternatives
HALO
SECTORUnlike BSX, which is fighting for share, HALO has a near-monopolistic position with its ENHANZE platform, providing a more durable moat and higher-visibility royalty revenue stream.
NBIX
SECTORWhile NBIX has concentration risk with its key drug Ingrezza, its market position is dominant (~60% share) and protected by patents into the mid-2030s, offering a clearer competitive outlook than BSX's contested PFA market.
Boston Scientific is transitioning from a diversified medical device manufacturer to a high-growth cardiovascular powerhouse, driven by leadership in new, multi-billion dollar markets like Pulsed Field Ablation (Farapulse) and Left Atrial Appendage Closure (WATCHMAN).
Filter all news through the lens of high-growth cardiovascular product cycles and their ability to offset slower growth in mature segments.
Farapulse or WATCHMAN revenue growth exceeding +15% YoY; positive clinical data for next-generation structural heart or electrophysiology products; market share gains in cardiology against Medtronic or Abbott; tuck-in acquisitions in high-growth adjacencies.
Cuts to FY2026 organic growth guidance below ~7%; named market share loss for Farapulse to Medtronic's PulseSelect system; negative reimbursement changes for WATCHMAN or TAVR procedures; significant safety issues or recalls for key growth products.
Quarterly fluctuations in lower-growth MedSurg businesses; minor beats or misses on total company revenue if not driven by key cardio products; early-stage pipeline announcements without near-term revenue impact; general hospital procedure volume commentary.
Repricing Catalyst
The successful commercialization of the FARAPULSE Pulsed Field Ablation (PFA) system for treating atrial fibrillation. This technology is a paradigm shift from traditional thermal ablation, offering improved safety and efficiency. Analysts see the Atrial Fibrillation ablation market as a significant TAM expansion opportunity, and Farapulse's early adoption is key to BSX sustaining premium revenue growth and justifying a higher valuation.
Cardiovascular Therapies
$13.4B TTM (67% of Total) · 68.8% MarginWhat It Is
WATCHMAN FLX (Left Atrial Appendage Closure); FARAPULSE (Pulsed Field Ablation System); AGENT Drug-Coated Balloon; S-ICD (Subcutaneous Implantable Defibrillator); drug-eluting stents; TAVR systems.
Who Pays & How
Hospitals and cardiac catheterization labs pay on a per-procedure basis. They choose BSX for clinically differentiated products that offer better patient outcomes, procedural efficiency, or address unmet needs. Physician training on a specific device platform creates significant switching costs and brand loyalty.
Competition
Medical Surgery (MedSurg)
$6.6B TTM (33% of Total) · 68.8% MarginWhat It Is
Endoscopy scopes and tools (e.g., OverStitch); Urology and Pelvic Health devices (e.g., Rezūm); Neuromodulation devices (Spinal Cord Stimulators).
Who Pays & How
Hospitals and specialty clinics (e.g., Ambulatory Surgery Centers) pay on a per-unit basis for devices that enable less invasive procedures, reduce recovery times, and lower total cost of care.
Competition
External Quote Links
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| MarketWatch | Unusual Whales |
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| FinViz |
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