BSX Posts Q4 Earnings: Should You Buy, Sell or Hold the Stock?

Core Insights - Boston Scientific (BSX) reported strong fourth-quarter results for 2025, exceeding both revenue and earnings guidance, with over $20 billion in sales and 12.7% organic revenue growth [1][8] - The company faced challenges in Urology due to supply-chain issues and competitive pressures in Electrophysiology, leading to a 17.6% drop in stock price post-earnings announcement [2][3] Financial Performance - Boston Scientific achieved mid-teens growth for the second consecutive year, attributed to innovation and execution across business units [1] - The company expects organic growth of 10%-11% for 2026, despite near-term challenges [9][12] Segment Highlights - WATCHMAN business grew 29% year-over-year in Q4, supported by strong adoption in U.S. procedures and a strategic partnership with Siemens Healthineers [4] - Neuromodulation sales increased by 10% in Q4, with a full-year organic growth of 8%, bolstered by new product offerings and expanded reimbursement coverage [5] - APAC region sales surged 15% operationally in Q4, driven by strong performances in Japan and China [6] Market Position and Challenges - Boston Scientific holds approximately 65% market share in the PFA market, with expectations to exceed the 15% market growth rate despite competitive pressures [10] - The company announced acquisitions of Valencia Technologies and Penumbra to enhance its urology and cardiovascular capabilities [11] Profitability Outlook - Adjusted gross margin is expected to remain stable, with operating margin projected to expand by 50-75 basis points, and adjusted EPS anticipated to grow by 12%-14% [12] - First-quarter 2026 revenue growth is guided at 8.5%-10%, facing challenges from product discontinuations [13] Valuation Metrics - Boston Scientific trades at a forward Price/Sales (P/S) ratio of 4.87, which is below its historical median but above the industry average of 2.67 [17] Conclusion - Despite recent stock performance challenges, Boston Scientific's strong fundamentals and growth potential in key segments suggest a prudent hold for investors, with an attractive valuation relative to competitors [18]