BSX Stock Dips in Premarket Trading Despite Q4 Earnings, Revenue Beat

Core Insights - Boston Scientific Corporation (BSX) reported fourth-quarter 2025 adjusted earnings per share (EPS) of 80 cents, a 14.3% increase from the previous year, surpassing the Zacks Consensus Estimate by 2.6% and exceeding the company's guidance of 77-79 cents [1][2] - The company's full-year adjusted EPS reached $3.06, marking a 21.9% increase from 2024, also exceeding the Zacks Consensus Estimate by 0.7% and the 2025 guidance range of $3.02-$3.04 [2] Revenue Performance - Fourth-quarter revenues totaled $5.29 billion, reflecting a 15.9% year-over-year increase on a reported basis and 14.3% on an operational basis, with organic growth of 12.7% [3] - For the full year 2025, revenues were $20.07 billion, up 19.9% on a reported basis, 19.2% operationally, and 15.8% organically compared to 2024 [4] Regional Revenue Breakdown - In Q4, revenues increased by 17% in the United States, 12.4% in Europe, the Middle East and Africa (EMEA), 15.2% in the Asia Pacific, and 15.9% in Latin America and Canada [5] Segment Performance - MedSurg revenues in Q4 were $1.81 billion, up 15.9% year over year, with Endoscopy generating $760 million (8.2% organic growth) and Urology revenues at $717 million (3.2% organic growth) [7] - The Cardiovascular segment generated $3.48 billion in Q4 revenues, an 18.2% increase reported and 16.1% organically year over year [10] Margin Analysis - The gross margin expanded by 172 basis points to 69.6%, while adjusted operating margin increased by 180 basis points to 24% despite rising costs [11] Future Outlook - For 2026, Boston Scientific anticipates net sales growth of approximately 10.5-11.5% on a reported basis and 10-11% organically, with adjusted EPS expected in the range of $3.43-$3.49 [12] - Q1 2026 revenue growth is projected at 10.5-12% on a reported basis and 8.5-10% organically, with adjusted earnings expected between 78-80 cents per share [13] Strategic Developments - The company achieved broad regulatory approvals and clinical milestones across various franchises, including strategic acquisitions to enhance its vascular and neuromodulation portfolio [15]