With a combined revenue of $21 trillion and $2.1 trillion in profits, the 2026 Fortune 500 is the definitive list of America's largest companies.

Fortune 500

The 300 companies on this year’s list brought in over $12.5 trillion in revenue for the latest 12 months, with the median revenue figure at $24 billion.

America's Most Innovative Companies

AI is a major force shaping this year’s list—but it’s far from the only story.

World's Most Admired Companies

Almost $20 trillion in revenue—and a record-breaking $1.87 trillion in profits. Introducing the 2025 Fortune 500, the definitive list of the biggest companies in America.

The 300 companies on this year’s list brought in over $12.6 trillion in revenue for the latest 12 months, with the median revenue figure at $22 billion.

Leaders in all industries rely more than ever on Big Tech—and appreciate the giants that deliver, at scale, without drama.

Industries included in the sector are insurance and managed care, medical products and facilities, pharmacy services, and pharmaceutical companies.

Fortune Sector Leaders: Health Care

The Fortune 500, in its 70th year in 2024, ranks the biggest U.S. companies by revenue.

The 200 companies on this list are transforming industries from the inside out.

The 26th edition of the list shows how much esteem Big Tech giants command among other business leaders.

The 25th Fortune World’s Most Admired Companies list suggests that tech giants’ peers respect them as much as ever.

The Fortune 500, in its 69th year in 2023, ranks the biggest U.S. companies by revenue.

Just as it dominates our economy, Big Tech now dominates Fortune’s annual ranking of corporate reputation.

This year’s Fortune 500 marks the 68th running of the list.

After a year in which humanity leaned more heavily than ever on tech giants, see which companies topped Fortune's ranking of corporate reputation.

This year’s Fortune 500 marks the 67th running of the list.

F500-2021-305-Boston Scientific

Incorporated in 1979, Boston Scientific develops and manufactures medical devices for customers in the U.S. and various international markets and emerging markets. The slowdown in elective surgeries in 2020, due to the pandemic, hurt Boston Scientific's business: Revenue sank 8% to $9.9 billion and the company lost $82 million. In the first quarter of 2021, however, the company reported sales growth in each of its reportable segments and an 8% year-over-year increase in net sales.

For an astounding 13th straight year, Apple claims the top spot in Fortune’s annual ranking of corporate reputation, based on a survey of almost 3,800 executives, directors, and analysts.

This year's Fortune 500 marks the 66th running of the list.

F500-2020-296-Boston-Scientific

Boston Scientific makes medical devices such as pacemakers and stents for a number of health conditions.

Here are the World's Most Admired Companies for 2019 as ranked in their industries. See who made the list.

This year's Fortune 500 marks the 65th running of the list.

Here are the World's Most Admired Companies for 2018 as ranked in their industries. See who made the list.

This year's Fortune 500 marks the 64th running of the list.

Here are the World's Most Admired Companies for 2017 as ranked in their industries. See who made the list.

This year's Fortune 500 marks the 63rd running of the list.

Here are the World's Most Admired Companies for 2016 as ranked in their industries. See who made the list.

This year's Fortune 500 marks the 62nd running of the list.

This year's Fortune 500 marks the 61st running of the list. Wal-Mart claims the top spot again. See who made the list.

Wal-Mart stayed on top as its sales crept closer to half-a-trillion dollars. Apple moved into the top five. And UnitedHealth Group continued its steady climb. 

Sector

Industry

Current All-Star Rank

Previous All-Star Rank

Industry Rank

Previous Industry Rank

Overall Score

Innovation

People Management

Use of Corporate Assets

Social Responsibility

Quality of Management

Financial Soundness

Long-Term Investment Value

Quality of Products/Services

Global Competitiveness

Strongest Dimension

Years on list

Previous rank

State

Key Financials (last Fiscal Year)

Revenues ($M)

Profits ($M)

Assets ($M)

Total Stockholder Equity ($M)

Profit Ratios

Profit as % of Revenues

Profits as % of Assets

Profits as % of Stockholder Equity

Earnings Per Share (last Fiscal Year)

Earnings Per Share ($)

EPS % Change (from prior fiscal year)

EPS % Change (5 year annual rate)

EPS % Change (10 year annual rate)

Total Return

Total Return to Investors (last year)

Total Return to Investors (5 year, annualized)

Total Return to Investors (10 year, annualized)

Boston Scientific Corporation is a medical technology company that develops minimally invasive therapies and devices to address heart failure and rhythm disorders, gastrointestinal problems, and chronic pain. The company is known for its Watchman implant, designed to reduce the risk of stroke and heart attack in people with atrial fibrillation and to reduce their reliance on blood thinners.

Q2 2026

Q1 2026

Q4 2025

Q3 2025

Q2 2025

Q1 2025

Q4 2024

Boston Scientific (BSX): Company Profile, Stock Price, News, Rankings

legacy

Boston Scientific

boston scientific

Good morning, and welcome to the Boston Scientific First Quarter twenty twenty five Earnings Call. All participants will be in listen only mode. After today's presentation, there will be an opportunity to ask questions. Please note this event is being recorded. I would now like to turn the conference over to John Monson, Senior Vice President, Investor Relations.

Thank you, Drew, and thanks everyone for joining us. With me today are Mike Mahoney, Chairman and Chief Executive Officer and Dan Brennan, Executive Vice President and Chief Financial Officer. During the Q and A session, Mike and Dan will be joined by our Chief Medical Officer, Doctor. Ken Stein. We issued a press release earlier this morning announcing our Q1 results, which included reconciliations of the non GAAP measures used in this release.

The release as well as reconciliations of the non GAAP measures used in today's call can be found on the Investor Relations section of our website. Please note on the call all operational revenue excludes the impact of foreign currency fluctuations and organic revenue further excludes certain acquisitions and divestitures for which there are less than a full period of comparable net sales. Guidance excludes the previously announced agreement to acquire Sonneby and Entera Oncology, which are expected to close during the second quarter of twenty twenty five subject to customary closing conditions. For more information, please refer to the Q1 financial and operational highlights deck, which may be found on the Investor Relations section of our website. On this call, all references to sales and revenue are organic and relative growth is compared to the same quarter of the prior year unless otherwise specified.

This call contains forward looking statements regarding among other things our financial performance, business plans and product performance and development. These statements are based on our current beliefs using information available to us as of today's date and are not intended to be guarantees of future events or performance. If our underlying assumptions turn out to be incorrect or certain risks or uncertainties materialize, actual results could vary materially from those projected by the forward looking statements. Factors that may cause such differences are discussed in our periodic reports and other filings with the SEC, including the Risk Factors section of our most recent annual report on Form 10 ks. Boston Scientific disclaims any intention or obligation to update these forward looking statements, except as required by law.

So at this point, I'll turn the call over to Mike. Mike?

Thanks, John. Thank you everyone for joining us today. In Q1, we delivered excellent results, all while we continue to invest in our highly innovative portfolio and capabilities.

Importantly, we remain excited about our near and long term growth catalysts, which we believe will enable us to deliver on our fundamental aim of driving consistent differentiated performance this year and well beyond. In first quarter twenty twenty five, total company operational sales grew 22% and organic sales grew 18%, both exceeding the high end of our guidance range of 14% to 16%. Our strong growth continues to reflect the durability of our category leadership strategy, which is powered through the meaningful innovation, clinical evidence generation and the winning spirit of our highly engaged global team. First quarter adjusted EPS of $0.75 grew 34%, exceeding the high end of our guidance range of $0.66 to $0.68 First quarter adjusted operating margin was 28.9%. Turning to our second quarter and full year 2025 outlook, we are guiding to organic growth of 13% to 15% for the second quarter twenty twenty five and raising our full year guidance from 10% to 12% growth to 12% to 14% organic growth, reflecting the significant strength in our broad based cardiology portfolio and the global execution of our category leadership strategy across our business units.

Our second quarter adjusted EPS guidance of $0.71 to $0.73 and we expect our full year adjusted EPS to be $2.87 to 2.94 which represents growth of 14% to 17%. This also includes an approximate $200,000,000 impact from tariffs based on the information that is available today, which we expect to offset through sales upside and smart reductions in discretionary spending. Dale will provide more details on this within the financials. We remain committed to our diversified global manufacturing footprint, investing across all regions and notably within The U. S, where we recently opened our new site in Georgia, continue to increase our Minnesota manufacturing capacity and footprint to support long term growth.

I'll now provide some additional highlights on our first quarter results. Regionally, on an operational basis, The U. S. Grew 31% with double digit growth in five of our eight business units. Midway through Q1, we crossed the one year mark of The U.

S. Verapulse launch and the ten year anniversary of WATCHMAN's approval, two clinically impactful technologies that helped to transform the growth profile of Boston Scientific. Europe, Middle East and Africa grew 8% on an operational basis. This above market growth was led by exceptional performance in EP, as well as double digit growth in our anchor technologies across the broader portfolio, including complex PCI, TheraSphere and interventional oncology, Axios and Rezum. Asia Pacific grew 11% operationally, led by double digit growth in Japan.

Japan is on track to have an excellent year led by strong FerriPulse uptake and we continue to anticipate launching FerriWAVE NAV and Fairview in the second half of the year. China also delivered high single digit growth of a very tough 42% growth comp in first quarter twenty twenty four and we anticipate to deliver double digit growth despite ongoing DBP pricing impacts in China. I'll now provide some additional commentary on business units. As a reminder, we did have one less selling day in the first quarter of twenty twenty five, which impacted our growth by approximately 200 basis points. Urology sales grew 25% on an operational basis and 4% organically.

Growth in the quarter was driven by our core stone franchise and we're pleased to have completed our first Ascerus fluid management case in Chile. The service system is part of our interconnected StoneSmart ecosystem and we expect U. S. Clearance in the second half of twenty twenty five. Looking ahead, we continue to be excited by differentiated value Axonics brings and our ability to more broadly serve our customers, as we are pleased with the integration progress to date.

Endoscopy sales grew 6% both operationally and organically, with balanced growth regionally and across our broad and deep portfolio. We continue to see sustained double digit performance with our clinically differentiated Axios platform as well as double digit growth of both OverStitch and MANTIS CLIP, two very innovative technologies in our growing endoluminal surgery franchise. Neuromodulation sales grew 7% in the first quarter with mid single digit growth in our brain franchise and high single digit growth in our pain franchise. Within DBS, we saw improving growth exiting the quarter driven by early contribution, the launch of our Cartagio leads and acceleration of the Lumina three d programming algorithm in The U. S.

Within our pain portfolio, INTERCEPT grew strong double digits and we continue to see robust demand underpinned by five year data demonstrating the long term efficacy and cost effectiveness of this treatment. Cardiology delivered another fantastic quarter with sales growing 31%. Within cardiology, interventional cardiology therapies sales grew an impressive 9% and coronary therapies was driven globally by double digit growth in our imaging franchise and excellent performance from our novel agent DCB technology. In The U. S, Agent DCB momentum was fueled by strong reorder rates and new account openings, with additional reimbursement established in the outpatient setting as of January, and incremental inpatient reimbursement expected to follow later this year.

Within the quarter, we're also pleased to present the early feasibility results of our Vitalist circulatory support system, with data demonstrating positive early experience and 100% technical success rate. In addition, we recently announced our agreement to acquire SonyV, which has developed a clinical stage differentiated ultrasound based renal denervation technology. We look forward to closing this acquisition, which we expect in Q2 this year. WATCHMAN grew 24% this quarter, reflecting robust market growth and an increase in our market share driven by strong concomitant uptake, with over half of our U. S.

EP Implanting customers now have been performing at least one concomitant procedure. We continue to invest in global clinical evidence, most recently initiating the Option A trial in Asia Pacific, assessing the effectiveness of TheraPulse and WATCHMAN in a concomitant procedure. Within the quarter in The U. S, we completed a full conversion to WATCHMAN FlexPro, which is our third generation and market leading technology and we remain committed to increasing patient awareness and advancing physician training and workflow optimization. Looking ahead, we expect The U.

S. Label update for WATCHMAN as a first line alternative to OACs in post ablation patients in the second half of twenty twenty five and the CHAMPION AF data readout in the first half of twenty twenty six. Cardiac Rhythm Management sales grew 1% in the first quarter. Our Diagnostics franchise grew high single digits led by double digit growth in our LexDx category. In core CRM, our low voltage business grew high single digits and the high voltage business declined low single digits.

We've expanded our Connection System pacing offering with the recent launch of NextGen lead delivery catheters, which will provide physicians with additional tools to target the left bundle branch area of the heart. And further, anticipate FDA approval of Empower leadless pacemaker in the second half of twenty twenty five. Lymphophysiology sales grew 145% with fantastic performance across the globe. Globally, we are now the number two clear player in EP and we intend to continue to expand our leadership position in PFA through clinical evidence, next generation innovation, new offerings to fill portfolio gaps and commercial capabilities. Within the quarter, we saw high commercial demand for FerriPulse with strong sales and established accounts and rapid new account openings as the global market continues to convert to PFA, given the compelling safety, efficacy and efficiency profile.

At Iroh earlier this month, results from the investigator sponsored single shot champion clinical trial demonstrate that Parapulse achieved superior effectiveness for the treatment of symptomatic peroxisomal AF versus cryoablation. Importantly, this is the first prospective randomized demonstration of PMA superiority over any thermal ablation modality. We also continue to see strong adoption of our Opel HD X integrated mapping solution, which provides operators enhanced visualization and confirmation of upholstered applications. In first quarter, we completed enrollment in the avaGAR trial, which studies a new patient population of drug naive persistent AF patients. We also initiated the complete the first human case in the ELEVATE trial, studying the FerriFlex catheter, which is our large focal high density map and a bleak catheter that integrates with the Opel HD X mapping system.

And tomorrow data from the ADDvantage Phase two trials studying FerroPoint will be rolled out at the PFA live case summit ahead of which we expect to support U. S. FDA approval by year end 2025. Also peripheral inventions grew an impressive 16% operationally and 7% organically. Our interventional oncology and embolization franchise grew double digits across the portfolio, driven by a broad offering of embolization devices and cancer therapy technologies.

In the quarter, we received FDA approval to expand the patient population and study additional areas in the brain in the FRONTEA trial, an early feasibility study for the use of TheraSphere to treat recurrent glioblastoma. We look forward to expanding our portfolio of offerings in this high growth space and continue to expect the acquisition of Entera Oncology to close in second quarter twenty twenty five. Within our vascular franchise, we saw mid single digit growth in arterial and double digit growth in venous in first quarter. And earlier this month, we completed the acquisition of Bolt Medical and also received FDA clearance of the IVL system for above the knee indication. We aim to initiate a limited launch by the end of twenty twenty five as we ramp supply following the acquisition close and earlier than anticipated regulatory approval.

On the coronary front, we continue to progress the fracture trial now having enrolled patients in The U. S. Before I turn the call over, as you saw in our press release this morning, Dan Brennan has decided to retire from Boston Scientific after an outstanding thirty year career, including the last twelve years as our CFO, who will be succeeded by John Munson, who you know from his time leading Investor Relations at the June. Laurent Tanguin will return to Investor Relations and succeed John. I would like to personally thank Dan for his leadership, his great friendship and his many contributions over his remarkable career.

Dan has been instrumental in transforming the trajectory of our financial performance and building the strong culture and values that are embedded throughout Boston Scientific. Thank you, Dan. And in closing, I'm grateful to our talented team of global employees who work every day to advance science for life and I'm confident in the sustainability of our top tier financial performance. With that, I'll turn it over to Dan.

Thanks Mike and thanks for the kind words.

First quarter consolidated revenue of $4,663,000,000 represents 20.9% reported growth versus first quarter twenty twenty four and includes a 130 basis point headwind from foreign exchange, which was unfavorable versus our expectations. Excluding this 49,000,000 foreign exchange headwind, operational revenue growth was 22.2% in the quarter. Sales impact from closed acquisitions contributed 400 basis points, resulting in 18.2% organic revenue growth, exceeding our first quarter guidance range of 14% to 16%. Q1 twenty twenty five adjusted earnings per share of $0.75 grew 34% versus 2024, exceeding the high end of our guidance range of $0.66 to $0.68 primarily driven by our strong sales performance in the quarter. Adjusted gross margin for the first quarter was 71.5%, which represents a 170 basis point improvement versus the first quarter of twenty twenty four.

This strong performance was primarily driven by favorable product mix in the quarter. First quarter adjusted operating margin was 28.9. This was favorable to our expectations due to our strong gross margin performance and timing of internal investments planned for the year. On a GAAP basis, first quarter operating margin was 19.8%. Moving to below the line, first quarter adjusted interest and other expenses totaled $106,000,000 On an adjusted basis, our tax rate for the first quarter was 9.8%, which includes favorable discrete tax items related to the benefit from stock compensation accounting.

Our operational tax rate was 13.6% for the quarter. Fully diluted weighted average shares outstanding ended at $1,493,000,000 shares in the first quarter. Free cash flow for the first quarter was $354,000,000 with $541,000,000 from operating activities less $187,000,000 in net capital expenditures. We continue to expect full year 2025 free cash flow to be in excess of $3,000,000,000 As of 03/31/2025, we had cash on hand of $725,000,000 We used $1,000,000,000 of the $1,500,000,000 euro denominated senior note offering completed on February 26 to repay approximately $1,000,000,000 of euro denominated notes that matured in March 2025. During the quarter, we were pleased to receive credit rating upgrades to single A minus from both Standard and Poor's and Fitch ratings.

Our gross debt leverage ratio was 2.2 times. Our top capital allocation priority remains strategic tuck in M and A followed by annual share repurchases. In alignment with the strategy, we recently closed the acquisition of Bolt Medical, which complements our existing interventional cardiology and peripheral portfolios. We expect to offset the associated earnings per share dilution through internal cost efficiencies and trade offs. Our legal reserve was $316,000,000 as of March 31 with $48,000,000 of this reserve already funded through our qualified settlement funds.

I'll now walk through guidance for Q2 and full year 2025. We now expect full year 2025 reported revenue growth to be in a range of 15% to 17% versus 2024. Excluding an approximate 50 basis point headwind from foreign exchange based on current rates, we expect full year 2025 operational growth to be in a range of 15.5% to 17.5%. Excluding a three fifty basis point contribution from closed acquisitions, we expect full year 2025 organic revenue growth to be in a range of 12% to 14% versus 2024. We expect second quarter twenty twenty five reported revenue growth to be in a range of 17.5% to 19.5% with a neutral impact from foreign exchange based on current rates.

Excluding a four fifty basis point contribution from closed acquisitions, we expect second quarter twenty twenty five organic revenue growth to be in a range of 13% to 15% versus 2024. We now expect full year adjusted gross margin to be roughly in line with 2024, reflecting the impact of newly enacted tariffs. Despite this headwind, we remain on track to deliver 50 to 75 basis points of adjusted operating margin expansion for the year. We continue to expect full year 2025 adjusted below the line expenses to be approximately $425,000,000 Under current legislation, including enacted laws and issued guidance, we continue to forecast the full year 2025 operational tax rate of approximately 13.5% and an adjusted tax rate of approximately 12.5%. We expect full year adjusted earnings per share to be in a range of 2.87 to $2.94 representing growth of 14% to 17% versus 2024, including an approximate $0.04 to $05 headwind from foreign exchange.

We expect second quarter adjusted earnings per share to be in a range of $0.71 to $0.73 Before I turn it back to John, I want to address the evolving trade environment. With the current schedule of expected tariffs, we forecast an approximate $200,000,000 impact in 2025. We expect to fully offset this $200,000,000 unanticipated headwind through our full year organic sales guidance raise, targeted discretionary spend reductions and a $01 FX benefit. Additionally, tariffs are capitalized in the inventory and recognized in the P and L over the course of finished goods inventory turns. Therefore, the Q2 impact from tariffs will be minimal and we expect to see most of the tariff impact in the second half of the year.

These effects are fully contemplated in the guidance ranges we are sharing today. In closing, I'd like to thank my Boston Scientific teammates over the nearly thirty years for making this such an extraordinary place to call home. Special thanks to Mike for choosing me for this role twelve years ago. I've thoroughly enjoyed our collaborations. I'm thrilled for John as he assumes the CFO role and I look forward to seeing all the great things he and the team will accomplish for physicians, patients, BSC teammates and investors in the years to come.

Thanks so much, Dan. Well, Drew, let's open up the questions for the next forty minutes or so. In order for us to take as many questions as possible, please limit yourself to one question. Drew, please go ahead.

We will now begin the question and answer session. The first question comes from Robbie Marcus with JPMorgan. Please go ahead.

Great. Good morning and congrats on a fantastic quarter.

Dan, wish you all the best in retirement and John congratulations. I hate to start off on such a great quarter with a tariff question. I'll leave the good performance for others to ask. But just on tariffs here, it's really impressive you're able to offset. It looks like about $0.11 or so by my math for half year.

How do we think about the ability as you move through the rest of the year to maybe move around some of the manufacturing? I imagine FX is still a big tailwind for next year at current rates given your hedging program. And how you're thinking about the different buckets of tariffs and your ability to offset them? Thanks a lot.

Sure, Robbie. Just to be clear. So as you said, we have a $200,000,000 tariff headwind for 2025. Based on the fact that we capitalized tariffs as you would expect, Q2 doesn't have much in the way of incremental tariffs from the recent announced tariffs. So it's mostly a second half challenge.

So what we're doing is effectively offsetting that with the increase in the revenue performance. So you saw us raise our revenue range to 12% to 14%. We do have some targeted discretionary spend reductions, travel meetings. Actually we have some programs going there and we're just looking to accelerate those programs to deliver more savings. And then we do get $01 of FX benefit.

So the way I look at it is the revenue and the FX kind of offsets half and then the discretionary spend reductions offset the other half. So we're really pleased that we're able to continue the momentum of the company and drive the raise in the revenue guidance range and the raise in the adjusted EPS guidance range. Relative to moving manufacturing around, we're not making any decisions now relative to moving infrastructure or anything around moving manufacturing around the globe. As Mike mentioned, we just made some significant investments both in Minnesota and in Georgia and significant capacity and bricks and mortar there. So we have a long standing very well optimized supply chain around the globe and not looking to make any changes to that as we sit here today.

The next question comes from Larry Biegelsen with Wells Fargo. Please go ahead.

Thanks for taking the question and congrats on a really strong quarter. And of course, congratulations to Dan and John. Me, Dan, thanks for all your help over the years and I'll miss working with you. So Mike, you mentioned that you're now number two in EP. And so the market shares look very different in The U.

Being much higher. So my questions are Mike, one, do you think you can overtake J and J to become number one in EP? And second, what will it take for the OUS share to catch up to The U. S. Share?

Sure. We have just excellent momentum broadly around the globe in EP. So I won't speculate as to when we might we certainly aim to be number one in that business. It'll take a few years to potentially reach that goal, but it's clearly what our aim is. And it's supported based on the clinical science, the breadth and depth of our PSA leadership position that we have and a significant investment that we're making in it around the world.

So in terms of The U. S. Is doing extremely well. Europe has also had excellent growth despite lapping one year comps with their FerriPulse launch already, which shows you that durability and enthusiasm despite competitive entrants. The European business grew significantly quickly in the first quarter twenty twenty five.

And we're really still early days, very early days in China. So China represents a plus $1,000,000,000 market. And it's an area that we're making significant investments in clinical and mapping and capabilities in China. So I think you'll see ongoing impact benefit for us throughout the year in 2025 in China and a much bigger impact in 2026 in China. And our Japan team really did has done an amazing job with launch of Verapulse.

And we're a clear number one leader in PFA, despite being the third approval in Japan. So very impressed with the execution in Japan and The U. S. And in Europe. And our China team is really building the blocks now to do the exact same thing in China.

So our aim is to continue our leadership in PFA. You're seeing massive adoption to PFA usage and we have a lot of momentum.

The next question comes from Joanne Wuensch with Citi. Please go ahead.

Good morning and thank you for taking the question. And congratulations to everybody all around. Dan, it's been a real pleasure to work with you over the years. I do want to spend a minute or two talking about the WATCHMAN franchise, which poked its head back above 20% year over year growth and made some comments on concomitant procedures and additional data. If you can just unpack that a little bit for us that would be great.

Sure. We had an excellent quarter with WATCHMAN. It's 24%. And then as we said, all of our businesses were impacted by about 200 bps of one less day sale. So the WATCHMAN sales were excellent in the first quarter and Ken Stein can comment a bit more, But we're seeing very strong adoption of concomitant.

Based on the safety profile, ease of use, the benefits for the hospital, the benefits to patients, physician, it's really it's great to see the stars aligned to doing the right thing for the patient, right thing for the hospital system. And we happen to have the leading product in the LAC category and the leading product in the PFA category. And we actually gained share with LAC in the quarter, which is impressive. And we continue to invest significantly in clinical trials and next gen products with WATCHMAN as well. So Doctor.

Yes. Thanks Mike. And Joanna, Mike was saying, right,

what we've really seen over the course of the quarter is a couple of phenomena. And one is the physicians are really now digesting the incredible strength of the data from the Option clinical trial, right, which was read out last year. We will have more data from OPTION to be presented at the upcoming HRS meeting. People are also, I think, just getting more accustomed to the workflow and really just how straightforward the work flow can be doing a Perthrombin procedure, particularly if it's done in conjunction with using TheraPulse. People also frankly are also getting used to some of the economic advantages both to hospitals, but also to physicians in doing this procedure in an efficient manner under the current reimbursement.

So all of that has led to uptake of concomitant procedures that has been frankly faster than we would have expected, say, a quarter or two ago. And just to reiterate what Mike said, it's one of those unique things that it's good for patients, first of all, avoids the need to have two procedures. It's also good for docs and good for hospitals and good for the system altogether.

The next question comes from Rick Wise with Stifel. Please go ahead.

Good morning, Mike. Maybe talk if you would about not tariff specifically, but sort of other aspects of the trade wars and the potential or current impact on Boston. For example, I was impressed that you still feel like you're going to see double digit growth in China. But maybe talk to us about the environment and how it's how some of these trade battles are complicating Boston's performance there. And maybe just related to that, are you concerned at all?

Are you anticipating supply chain disruptions or concerns? How are you planning for that? Just talk about those topics. Thank you.

Well, one is the company's delivered excellent results on top line and bottom line. So our ability to absorb the tariffs, I think is more unique than most companies given the strength of the growth and the leverage that we're driving to absorb the $200,000,000 which is unfortunate, but we're able to absorb it and still deliver very high performance. Our operations team is excellent and we have manufacturing across the globe. And as Dan said, there's no major adjustments other than continuing investment to support the long term growth of the company. A lot of investments in The U.

S, some in Malaysia and once that makes sense to facilitate our global operations. China is a very complex market. John or Dan, it represents seven percent or 8% of our sales approximately. And the team there, despite the challenges, does a great job. We expect to deliver double digit growth again, despite being one of the more impactful VBP impacts for Boston Scientific in 2025 across the PI portfolio and some ITTX and some endo.

So a lot of VBP pressure there. But again, innovation that we have, some of the local partnerships that we've done in China are proving to be beneficial. And we do have some small manufacturing capabilities in China, which also makes sense. So we think we our manufacturing footprint makes the most sense for the long term. And we'll continue to invest in that to grow.

It's a dynamic of market, but our team is the winning spirit of the Boston Scientific team. We find ways to deal with reality and deliver high performance. And you see we're very bullish on our full year outlook based on the guidance that we gave in sales and EPS.

And thanks to Dan for everything. Congrats on a well deserved retirement. Hope you won't miss The

next question comes from David Roman with Goldman Sachs. Please go ahead.

Thank you. Good morning, everyone. Maybe we could switch gears and talk a little bit about the MedSurg business. And Mike in your prepared remarks, you did talk a little bit about the turn in neuromodulation here with Relievant going organic and the durability of kind of the category leadership strategy and the dynamics you're seeing in the peripheral business. But maybe you could talk a little bit about the path from the 5% -ish organic growth we saw in Q1 here?

And what are the drivers to move that back toward a high single digit growth rate, especially as Silk turns organic, Axonics turns organic, etcetera?

Sure. Yes. So again, the five is really a seven, if you look at the days. So kind of add or slightly above market overall, if you do the days adjustment there. And breaking it down, the Endo team continues to deliver at a high level when you factor in those days impact.

And with a broad based portfolio, we expect to see kind of consistent results in that business. The Neuromod team is really starting to strengthen its capabilities. We believe it has gone organic, which is certainly helpful. And we continue to invest quite a bit in that platform as well as continue to strengthen our commercial capabilities organization. So we expect to see improvement in the neuromod results as the year goes on based on the momentum we have there as well as in DBS with the lead and so forth.

Axonics is going well. It's an excellent addition to our company and we continue to do integrate that company that will go organic, I think, in the fourth quarter or so this year as well as Silk Road well. And then urology was a tad under what we're used to from a urology team. Again, very impressed with the Axonics capability and really the global strength we have in our urology portfolio. We are experiencing some supply chain issues across some specific categories, which I won't go into detail that are impacting some back orders within urology business.

So we expect that to improve, but it'd be a bit of a headwind for us in 2025. And we continue to invest across that portfolio with our StoneSmart in our implant businesses. So we expect the urology business to kind of grow at market, I would say in 2025 and our endoscopy and neuromod business to grow above market and overall providing a really healthy balance to our excellent cardiology growth.

The next question comes from Travis Steed with Bank of America. Please go ahead.

Hey, congrats Dan on a well deserved retirement. Just wanted to say that upfront. And then I wanted to ask about margins this quarter.

It was a really strong margin quarter. I don't know if that's the EP growth turning margin accretive or anything else to call out. And on the tariff side, the $200,000,000 tariffs, not sure if you're giving kind of what you're assuming in that in terms of like where they're ready to go or after ninety days, how much of that's China versus Europe? And if the plan is still in 2026 that can be continued to offset the tariff headwinds as they go forward?

Sure. So let hit the tariffs one first and your second one first. Just to be 100% clear on what's in. So $200,000,000 tariff headwind for 2025 largely in the second half. It's as you have seen in the news as we have seen, which is a 10% blanket tariff through the end of the year.

The reciprocal tariff rates that were put in place on April 2 with the ninety day pause would then commence early in Q3. We've assumed they commence in early Q3. And tariff, it's the 145,000,000 U. S, 1 hundred 20 5 million China back and forth that's there now. And that's actually the largest component of that $200,000,000 for us now is the China piece.

I'm not going to get into 26,000,000 Obviously, very fluid situation there. Just really pleased that we've been able to offset the 200,000,000 that we see in front of us for this year, which will help us deliver 12% to 14% revenue growth, 14% to 17% EPS growth and 50 to 75 basis points of margin expansion, all in the face of a $200,000,000 headwind that we didn't anticipate until about twenty five days ago. When you look at the operating margin kind of building off of that 28.9% that was I will admit a little bit higher than I even thought it would be in Q1. So what's the driver of that? When Fire Pulse grows like it's growing and you see Watchmen in the mid-20s that's a big driver of gross margin.

You saw gross margin at 71.5%. I really like that number. Obviously tariffs will challenge that number as we go forward into the rest of 2025. Likely gross margin should be in line with where we were last year. So last year it was 70.3%.

I'd expect us to be kind of in that range because the $200,000,000 at the gross margin line for tariffs is kind of 100 basis points or north of 100 basis points of impact. And so the equation that I had laid out in February might look a little differently, right? But it just goes to the flexibility, the agility and the winning spirit of the team that when confronted with the $200,000,000 headwind, we originally thought gross margin would go north. We thought SG and A would go south. R and D would tick up a little bit and we deliver 50 to 75 basis points.

So now as we sit in April, gross margin is likely to go backwards. So what do you do? You look to take some actions, again discretionary actions for spending that we can eliminate and with no impact on the top line or long term growth and drive still drive the 50 to 75 basis points of expansion and get to that 27.5 to 27.75. So likely from the 28.9% that you see in Q1, we manage for the full year. The quarters you're always going see fluctuations.

You'll see the second half in particular be lower than the 28.9%, but we're confident in the 27.5% to 27.75% for the year and proud of it.

next question comes from Patrick Wood with Morgan Stanley. Please go ahead.

Beautiful. Thanks so much and congrats to both Dan and John. I'd love to just touch on CRM actually of all things.

And I'm curious, obviously, you saw the shift between high and low voltage. But I'm curious in terms of Empower and the approval of that in the second half, how you're thinking of the outlook for that provision? How much does Empower impacts growth going forward? Just any kind of details on the CRM side of things would love a little bit more. Thanks.

Sure. Really pleased with the future of CRM, I would say. So I'd say we're kind of slightly below market with those results. Most all of our businesses grew at or most of them grew above market. CRM and Tableau, which we expect likely to be the case for most of 2025.

But I think if you look at 2026 and beyond, and it really the momentum maybe towards the end of 2025, really confident in our CRM business. A lot of investment in CSP labeling, longevity changes, new CSP catheters. The Empower, we should have approval at some point in second half of twenty twenty five percent. That will have a nice larger impact in 2026. And also, one of the biggest organic investments we've had in the company for six years now is really the total product refresh of our S ICD, TACI and Brady portfolio called Denali, which will launch starting off with high power in 2026.

Boston Scientific (BSX) Q1 2025 Earnings Call Transcript

Company Participants