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    Medtronic PLC (MDT)

    MDT Q1 2026: CAS segment surges 50% sequentially; $1B growth in sight

    Reported on Aug 19, 2025 (Before Market Open)
    Pre-Earnings Price$92.81Last close (Aug 18, 2025)
    Post-Earnings Price$87.84Open (Aug 19, 2025)
    Price Change
    $-4.97(-5.36%)
    • Accelerating CAS Growth: The management highlighted that the CAS business is delivering nearly 50% sequential growth and remains on track to add an incremental $1 billion in annual revenue over the FY25 base, demonstrating robust market acceptance and scalability.
    • Massive Renal Denervation Opportunity: There is a strong consensus that renal denervation, with a target market of 18 million U.S. patients with uncontrolled hypertension, could evolve into a multibillion-dollar product category, supported by positive CMS commentary and growing physician adoption.
    • Enhanced Governance and Focus on Value Creation: The appointment of new independent board members and the formation of dedicated growth and operational committees underscore a renewed focus on portfolio optimization and capital allocation, which is expected to drive accelerated EPS growth and long-term shareholder value.
    • Dependence on pipeline execution: Management’s confidence hinges on new products (e.g., the next‐generation CAS systems and dual CGMs) delivering rapid revenue acceleration. However, delays or lower-than-expected uptake could weigh on overall performance, especially given the mix of slower-growing segments.
    • Weak domestic diabetes growth: Although international markets are showing strong performance, the U.S. diabetes business is lagging—attributed to a ramp-up timing issue with new CGM launches. This slower pace in the core U.S. market raises concerns about achieving the full potential of the portfolio.
    • Complexity from strategic reorganizations: The upcoming diabetes separation and increased investments in growth catalysts introduce operational and integration risks. These structural shifts may distract from organic improvements in legacy segments, thereby potentially pressuring margins and overall growth.
    MetricPeriodPrevious GuidanceCurrent GuidanceChange

    Organic Revenue Growth

    FY 2026

    Approximately 5%

    Approximately 5%

    no change

    Adjusted EPS

    FY 2026

    $5.50 to $5.60

    $5.60 to $5.66

    raised

    Tariffs Impact

    FY 2026

    $200 million to $350 million

    $185 million

    lowered

    FX Impact on Revenue

    FY 2026

    Neutral to $100 million tailwind

    $550 million to $650 million

    raised

    Operating Profit Growth

    FY 2026

    Approximately 7%

    Materially faster than revenue

    no change

    EPS Growth

    FY 2027

    High single-digit EPS growth

    High single-digit EPS Growth

    no change

    Organic Revenue Growth

    Q2 2026

    no prior guidance

    4.5% to 5%

    no prior guidance

    Adjusted EPS

    Q2 2026

    no prior guidance

    Expected to be in the range of $1.30 to $1.32

    no prior guidance

    TopicPrevious MentionsCurrent PeriodTrend

    Accelerating CAS Growth

    Q3 2025 discussed 22% growth driven by dual PFA platforms and expectations to reach a $1 billion business. In Q4 2025, growth accelerated to nearly 30% with strong product demand and key milestones such as Sphere360 excitement and revenue achievements.

    Q1 2026 reported nearly 50% growth with higher sequential improvements, robust US/Japan performance, and a target of an incremental $1 billion revenue gain.

    Consistent acceleration: Growth trends are moving upward with improved product performance and revenue targets, indicating greater market acceptance and operational momentum.

    Renal Denervation Opportunity

    In Q3 2025, the focus was on the U.S. market opportunity with expectations around NCA to NCD conversion and international progress. Q4 2025 emphasized efforts in training, reimbursement preparation, and a “long annuity” type revenue ramp.

    Q1 2026 highlighted the upcoming CMS final NCD for the Simplicity procedure, with strong optimism regarding market unlocking a multi‐billion dollar opportunity.

    Continued optimism: The emphasis remains on reimbursement and training with clearer CMS visibility, showing an evolution from preparatory actions to near-term execution.

    Diabetes Business Performance & Separation

    Q3 2025 detailed robust double-digit growth in the MiniMed 780G system and sensor updates with no mention of separation. Q4 2025 provided an extensive plan for a two-step separation process, including IPO and spin‐off, despite margin pressure from the Simplera ramp.

    Q1 2026 reiterated strong international growth (8% overall, 11% internationally), a significant production ramp for the Simplera sensor, and confirmed that the separation process is on track to complete within 15 months.

    Ongoing strength with strategic separation: The business continues to exhibit solid growth while actively progressing with its separation, reinforcing investor optimism and operational focus.

    Pipeline Execution & Product Innovation

    Q3 2025 highlighted a broad pipeline across CAS, structural heart, neuromodulation, and diabetes, with multiple growth drivers emerging. Q4 2025 further detailed next‐gen pumps, closed‐loop algorithms, robotics, and neurosurgery innovations.

    Q1 2026 showcased strong pipeline execution with advancements in CAS (50% growth), RDN, diabetes innovations (new sensors, MiniMed Flex pump), and continued R&D investments to fuel growth across segments.

    Expanded and deepening innovation: The product pipeline remains robust and diversified, with increased R&D spending and new product launches signaling a healthy and evolving innovation strategy.

    Margin Pressure & Operational Risks

    Q3 2025 noted improving margins (66.6% gross, 26.2% operating) thanks to pricing and efficiency, while Q4 2025 addressed margin pressures from the diabetes product ramp and tariffs with a 70 bps decline in gross margin.

    Q1 2026 reported an adjusted gross margin of 65.1% (down 80 bps YoY) yet highlighted ongoing pricing benefits and operational efficiency efforts, with raised EPS guidance supporting proactive management.

    Mixed sentiments with proactive management: After earlier margin improvements, pressures reemerged in Q1; however, strategic efficiency initiatives and pricing actions are counterbalancing these risks.

    Enhanced Governance & Capital Allocation

    Q3 2025 briefly mentioned capital returns (dividends and share repurchases) and tuck-in acquisitions as part of portfolio management. In Q4 2025, capital allocation was indirectly addressed via the diabetes separation and shareholder returns.

    Q1 2026 introduced formal enhancements in governance with the appointment of new independent board members and the creation of dedicated Growth and Operating Committees to drive portfolio optimization and strategic capital allocation.

    Emerging focus on governance: The new, structured approach to governance and capital allocation in Q1 signals a shift from ad hoc capital management to a systematic, strategy-driven process.

    Hugo Robotic Surgical System

    In Q3 2025, Hugo was noted for progressing toward FDA approvals, expanding global presence (over 25 markets), and early technology enhancements. Q4 2025 reported expanded indications (urology, hernia, benign GYN), integration with LigaSure, and increased procedure volumes in 30 countries.

    Q1 2026 described Hugo as well-received globally (now in over 30 countries) with tens of thousands of procedures performed, further FDA filings for additional indications, and a digital ecosystem that is rapidly expanding.

    Continued upward momentum: Hugo’s progress across multiple indicators—including expanded global adoption and digital integration—reinforces its status as a key surgical growth driver.

    Tariff Environment & Macroeconomic Pressures

    Q4 2025 discussed two tariff scenarios with an expected impact of $200–$350 million and highlighted broader macroeconomic pressures such as higher interest expenses and increased tax rates. Q3 2025 did not mention these topics.

    Q1 2026 noted an improved tariff scenario with an expected impact reduced to approximately $185 million, while ongoing efforts are maintained to mitigate external cost pressures.

    Improvement in external pressures: There is a noticeable reduction in the expected tariff impact from Q4 to Q1, reflecting effective mitigation, although macroeconomic challenges remain steady.

    China VBP Impact

    In Q3 2025, Peripheral Vascular experienced a low-single-digit decline due to China’s VBP, highlighting some volatility in that segment. Q4 2025 did not mention VBP issues.

    Q1 2026 shifted focus as the neurovascular business was significantly impacted by China’s VBP, with current efforts aimed at ramping up replacement products and addressing these challenges.

    Persistent but shifting challenge: While VBP affected Peripheral Vascular in Q3, Q1 now shows a notable impact on the neurovascular segment, indicating evolving pressures within China.

    1. Pipeline Targets
      Q: Is $2B annual CAS sales target on track?
      A: Management reaffirmed that nothing has changed—the plan is to add $1B incremental revenue off the FY25 base, which underscores their confidence in deploying the new CAS products and potentially extending the ramp into FY27.

    2. CAS Growth
      Q: How does CAS drive overall U.S. performance?
      A: Management explained that while U.S. base growth remains modest at around 3.5%, the CAS segment is accelerating with nearly 50% growth, thanks to strong sequential performance and increased supply capacity.

    3. Renal Denervation
      Q: Can RDN become a multibillion-dollar market?
      A: Management emphasized that with the supportive CMS comments and a sizable uncontrolled hypertensive population—roughly 18 million U.S. patients—RDN is positioned to be transformative and could emerge as one of their largest markets.

    4. Diabetes Outlook
      Q: Is the U.S. diabetes business ramping up post-separation?
      A: Management noted there’s no disruption; U.S. production is expected to double in the latter half, with the imminent launch of both Simplera and Instinct sensors fueling a robust innovation cycle ahead of the planned IPO separation.

    5. Hugo/Robotics
      Q: How is Hugo progressing for the U.S. market?
      A: Management shared that international success and a strong modular design underpin Hugo’s potential, with regulatory filings and rising procedure volumes across over 30 countries suggesting a promising U.S. launch.

    6. Board Committees
      Q: What role will the new board committees play?
      A: The new growth and operating committees are set to increase focus through more frequent, strategic discussions, leveraging experienced medtech directors to drive enhanced shareholder returns and sustain margin improvements.

    7. Other Portfolio Drivers
      Q: How will other products boost slower segments?
      A: Management pointed to organic initiatives—such as advancements in neurovascular and pelvic health—along with new partnerships and product enhancements to strengthen traditionally slower areas and support overall portfolio growth.