Q4 2024 Earnings Summary
- Boston Scientific is experiencing strong momentum across multiple regions and business units, with more tailwinds than headwinds, driven by key products like FARAPULSE and AGENT, and expects to grow faster than the market in 2025.
- The interventional oncology and embolization division is performing exceptionally well, growing mid-teens for the full year, aided by successful product launches and strategic acquisitions like Intera Oncology, positioning the company for accelerated growth in this high-potential area.
- Despite anticipated price cuts in China and Japan, Boston Scientific expects to continue growing in these markets and improve operating margins, demonstrating resilience and effective cost management, which will contribute positively to the company's overall performance.
- Potential increased competition in the PFA (Pulsed Field Ablation) market in 2025 could pose a headwind for Boston Scientific's growth in this area. The company acknowledges that stronger PFA competition is possible, which may impact market share and revenues.
- Price pressures in China due to more extensive Drug Bulk Purchasing (DBP) policies in 2025 may negatively affect Boston Scientific's revenues and margins in this key market. The company anticipates more DBP headwinds this year, which could challenge growth despite strong performance.
- Challenges in the U.S. Cardiac Rhythm Management (CRM) business, including share loss in pacemakers due to the lack of a leadless pacemaker offering until late 2025, may impact Boston Scientific's competitive positioning. The company acknowledges maintaining unit volume share but experiencing dollar share loss in pacemakers.
| Metric | YoY Change | Reason |
|---|---|---|
Total Revenue | +22% (from $3,725M to ~$4,560M) | Strong commercial execution and product innovation, including accelerated adoption of new technologies, drove total revenue growth. The revenue base from Q4 2023 benefited from robust demand across segments—with acquisitions and expanded geographic reach further boosting sales. |
MedSurg Revenue | +12% (from $1,441M to $1,619M) | Consistent operational momentum, building on previous organic growth in key areas such as Endoscopy and Urology, fueled MedSurg expansion. Incremental growth reflects sustained product demand and improved market share gains similar to Q3 trends. |
Cardiovascular Revenue | +29% (from $2,285M to $2,942M) | Exceptional growth driven by rapid adoption of innovative products like Farapulse and WATCHMAN, as well as strong geographic expansion. Building on the previous period’s performance, the segment showed accelerated momentum—consistent with Q3 2024 trends where new acquisitions and market penetration were pivotal. |
Neuromodulation Revenue | Sharp decline (from $269M to $3M) | A dramatic drop likely reflecting strategic realignment, divestitures, or reclassification of neuromodulation assets. While prior periods showed steady performance, the near-complete reduction this period signals significant portfolio changes warranting further investigation. |
U.S. Revenue | +31% (from $2,213M to $2,893M) | Robust domestic demand—driven by rapid adoption of new platforms like the Farapulse PFA system and enhanced commercial initiatives—propelled U.S. revenue growth. This strong U.S. performance builds on previous trends where strategic product innovation and execution delivered solid market gains. |
Operating Income | +96% (from $584M to $1,143M) | Operating income nearly doubled as higher sales volumes and an improved product mix boosted gross profit, while cost efficiencies and favorable non-recurring credits contributed. The improvement reflects a consistent focus on margin expansion seen in previous periods, now magnified by strong revenue growth. |
Net Income | +11.5% (from $504M to $562M) | Net income growth was driven by higher overall revenue and improved operational leverage. Although operating expenses and acquisition-related charges increased, the benefit of enhanced margins and effective cost management helped maintain net income improvements relative to the prior period. |
Basic EPS | +12% (from $0.34 to $0.38) | Increasing profitability and operational efficiency, reflected in the modest EPS improvement, helped boost shareholder returns. The EPS growth mirrors underlying improvements in net income and reflects positive adjustments compared to prior quarters despite some non-operational charges. |
| Metric | Period | Previous Guidance | Current Guidance | Change |
|---|---|---|---|---|
Reported Revenue Growth | Q4 2024 | 16.5% to 18.5% | no current guidance | no current guidance |
Operational Revenue Growth | Q4 2024 | 16% to 18% | no current guidance | no current guidance |
Organic Revenue Growth | Q4 2024 | 14% to 16% | no current guidance | no current guidance |
Adjusted EPS | Q4 2024 | $0.64 to $0.66 | no current guidance | no current guidance |
Reported Revenue Growth | FY 2024 | 16.5% | no current guidance | no current guidance |
Operational Revenue Growth | FY 2024 | 17% | no current guidance | no current guidance |
Organic Revenue Growth | FY 2024 | 15% | no current guidance | no current guidance |
Adjusted Operating Margin | FY 2024 | 27% | no current guidance | no current guidance |
Adjusted Below-the-Line Expenses | FY 2024 | $300 million | no current guidance | no current guidance |
Operational Tax Rate | FY 2024 | 13.5% | no current guidance | no current guidance |
Adjusted Tax Rate | FY 2024 | 12.5% | no current guidance | no current guidance |
Adjusted EPS | FY 2024 | $2.45 to $2.47 | no current guidance | no current guidance |
Free Cash Flow | FY 2024 |
| no current guidance | no current guidance |
Reported Revenue Growth | Q1 2025 | no prior guidance | 17% to 19% | no prior guidance |
Operational Revenue Growth | Q1 2025 | no prior guidance | 18% to 20% | no prior guidance |
Organic Revenue Growth | Q1 2025 | no prior guidance | 14% to 16% | no prior guidance |
Adjusted EPS | Q1 2025 | no prior guidance | $0.66 to $0.68 | no prior guidance |
Adjusted Tax Rate | Q1 2025 | no prior guidance | 11.5% | no prior guidance |
Reported Revenue Growth | FY 2025 | no prior guidance | 12.5% to 14.5% | no prior guidance |
Operational Revenue Growth | FY 2025 | no prior guidance | 13.5% to 15.5% | no prior guidance |
Organic Revenue Growth | FY 2025 | no prior guidance | 10% to 12% | no prior guidance |
Adjusted EPS | FY 2025 | no prior guidance | $2.80 to $2.87 | no prior guidance |
Adjusted Operating Margin Expansion | FY 2025 | no prior guidance | 50 to 75 bps over 2024’s 27.0% | no prior guidance |
Adjusted Tax Rate | FY 2025 | no prior guidance | 12.5% | no prior guidance |
Operational Tax Rate | FY 2025 | no prior guidance | 13.5% | no prior guidance |
Adjusted Below-the-Line Expense | FY 2025 | no prior guidance | $425 million | no prior guidance |
Free Cash Flow | FY 2025 | no prior guidance |
| no prior guidance |
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Long-Term Growth Expectations
Q: Can you maintain double-digit growth beyond 2025?
A: Management aims to outgrow markets expected to reach a 9% WAMGR by 2026. They are confident in continuing double-digit EPS growth despite potential tax rate increases. -
Margin Expansion and Cash Flow
Q: How will you manage margins and cash flow in 2025?
A: They plan to improve gross margins by 50 to 75 basis points over the 70.3% in 2024 , leveraging SG&A and slightly increasing R&D spend by 20–30 basis points. Free cash flow conversion reached 71% in 2024 , and the capital allocation strategy remains focused on high-quality tuck-in M&A and annual share repurchases. -
PFA Competition Impact on Guidance
Q: Is your guidance conservative given potential PFA competition?
A: The guidance is thoughtfully set with more tailwinds than headwinds. While stronger PFA competition could emerge in 2025, they focus on driving momentum in FARAPULSE and other growth areas. China DBP challenges persist, but they expect mid-teens growth in China despite these headwinds. -
PFA and WATCHMAN Performance
Q: How did FARAPULSE and WATCHMAN perform, and outlook?
A: Both products have excellent momentum. FARAPULSE achieved over $1 billion globally in 1 year , transforming the market with strong execution. WATCHMAN benefited from concomitant reimbursement changes, reinforcing a 20% market CAGR for 2025. -
Electrophysiology and Mapping Strategy
Q: What's your strategy for EP market expansion and mapping?
A: They aim to maintain an open platform, supporting cases with or without mapping. Anticipate labeling expansion for FARAPULSE in persistent AF by end of the year , broadening the addressable market which is at least as large as the paroxysmal AF population.