Key Takeaways BSX's EP business is expected to grow nearly 15% over the LRP, driven by share gains and ICE entry.BSX's WATCHMAN remains the top LAAC device, with growth tied to positive OPTION and CHAMPION trial results.Boston Scientific's ICTx, its most global cardiovascular unit, targets 10% growth and aims to beat markets.Boston Scientific’s (BSX) Cardiovascular segment operates in a $50 billion market, projected to grow nearly 9% over the 2026-2028 long-range plan (LRP). Management expects the business ...

Core Insights - Boston Scientific (BSX) and Resmed (RMD) are significant players in the global medical devices market, with market capitalizations of $142.4 billion and $35.72 billion, respectively [2] - The medical devices market is projected to grow at nearly 7% CAGR from 2025 to 2030, prompting an evaluation of investment opportunities in both companies [3] Boston Scientific Overview - Boston Scientific is experiencing strong performance in its Cardiovascular and MedSurg segments, with expectations for above-market growth through 2025-2026 [4] - The WATCHMAN device is a leading product in percutaneous left atrial appendage closure (LAAC), with a projected market expansion of approximately 20% in the coming years [5] - The company is gaining market share in electrophysiology, particularly with the FARAPULSE Pulsed Field Ablation System, which received FDA approval for expanded use in July 2025 [6] - Recent acquisitions, including Intera Oncology and Elutia's BioEnvelope business, support Boston Scientific's growth strategy and expansion into high-growth areas [7] - Emerging markets accounted for 15% of Boston Scientific's consolidated net sales in the first nine months of 2025, indicating significant long-term growth potential [8] Resmed Overview - Resmed is witnessing strong demand for its mask portfolio, including the AirFit and AirTouch ranges, and is focusing on direct-to-consumer markets in regions like China and India [9] - The company has launched new variants of its AirTouch F30i mask and continues to see strong sales from its AirSense device platforms [9] - Resmed is advancing AI integration in its digital health products, including the launch of the personal sleep health digital assistant, Dawn, in the U.S. [11] - The company is optimizing operations to improve gross margins and has made acquisitions like Somnoware and Ectosense to support its 2030 growth strategy [12] Financial Estimates and Performance - The Zacks Consensus Estimate for Boston Scientific's 2025 EPS indicates a year-over-year increase of 21.1% to $3.04, with a slight upward revision in the last 60 days [13] - Resmed's fiscal 2026 EPS consensus estimate of $10.84 reflects a 13.5% improvement over 2025, with a 3.3% increase in estimates over the past 60 days [15] - In the last 12 months, BSX shares have increased by 6.8%, while RMD shares have risen by 5.8% [16] Investment Considerations - Boston Scientific is highlighted for its divisional strength, ongoing momentum with the WATCHMAN device, and strategic acquisitions in high-growth markets [18] - Resmed remains focused on innovation and strong demand for its products, but Boston Scientific is currently viewed as the more attractive investment option based on recent performance [18] - Boston Scientific holds a Zacks Rank 2 (Buy), while Resmed has a Zacks Rank 3 (Hold) [20]

Core Insights - Boston Scientific (BSX) has a stretched valuation with a Value Score of C, trading at a forward five-year price/earnings (P/E) of 27.77X, which is above its median and the industry average of 20.01X [1] - The company's performance has been mixed over the past year, underperforming key rivals Abbott (ABT) and Medtronic (MDT), but still faring better than the industry and sector [2] Valuation and Market Position - BSX's P/E ratio is higher than the broader Medical sector's P/E of 21.03X, indicating an expensive valuation compared to peers [1] - Key competitors, Abbott and Medtronic, are trading at lower P/E ratios of 22.15X and 20.01X, respectively [1] Business Performance and Growth Drivers - WATCHMAN sales increased by 35% in Q3 2025, supported by growing U.S. concomitant use, while the Electrophysiology (EP) business surged 63% in the same quarter due to FARAPULSE adoption [9][15] - The Urology business is driving strong sales from the global stone management franchise, with expectations of improving growth through 2026 following recent European approvals [10] - Endoscopy is experiencing robust growth in anchor products, and the Intracept procedure for chronic vertebrogenic pain is a significant growth driver in Neuromodulation [11] Strategic Initiatives - Boston Scientific aims to outpace market growth across neuromodulation, urology, and endoscopy, which together serve a global market of $20 billion growing nearly 7% [12] - The planned acquisition of Nalu Medical will expand the portfolio into peripheral nerve pain, presenting additional growth opportunities [12] Future Outlook - Management expects approximately 25% of U.S. WATCHMAN procedures to be performed concomitantly by the end of 2025, with a projected market growth of roughly 20% in the coming years [14] - Analysts remain optimistic about the company's earnings for 2025 and 2026, indicating confidence in its growth trajectory [16] Conclusion - Despite a premium valuation, Boston Scientific's innovative portfolio and strategic execution position it well for long-term growth, particularly through its WATCHMAN and EP products [18]

Core Insights - Boston Scientific has experienced significant growth over the past few years and is looking to build on this momentum moving forward [1] - The company aims to highlight its current growth drivers, such as FARAPULSE and WATCHMAN, while also focusing on future opportunities in adjacent markets [2] Company Growth and Strategy - The recent Investor Day was successful in showcasing the excitement around Boston Scientific's current offerings and future potential [2] - The company emphasizes a strong market growth in the procedures it addresses, alongside a commitment to innovation to enhance product value [2]

Core Insights - Boston Scientific (BSX) reported an adjusted gross margin of 71% in Q3 2025, a 60-basis-point improvement year-over-year, primarily due to a favorable product mix and strong growth in electrophysiology (EP) and WATCHMAN units, although tariffs limited growth potential [1][4] - WATCHMAN's sales increased by 35% in Q3, with over 600,000 patients treated, driven by accelerated adoption in the U.S. and strong clinical evidence [2] - EP sales surged 63% year-over-year, supported by the growth of the Farapulse Pulsed Field Ablation (PFA) System, with expectations for global PFA penetration to reach about 50% by the end of 2025 [3] Financial Performance - The adjusted operating margin rose by 80 basis points to 28%, reflecting solid performance on the top line [1] - Full-year adjusted gross margin is expected to be slightly above 2024 levels, despite an estimated $100 million tariff headwind, with management projecting an operating margin expansion of approximately 100 basis points [4] Market Position and Valuation - Year-to-date, Boston Scientific shares have increased by 9.8%, outperforming the industry growth of 3.4% [7] - The company's shares trade at a forward 12-month Price-to-Sales (P/S) ratio of 6.59, which is lower than its median but above the industry average [9] Earnings Estimates - Earnings estimates for Boston Scientific are showing an upward trend, with current estimates for the current year at $3.04 and $3.45 for the next year [11]

Industry Overview - Cardiovascular disease is the largest contributor to healthcare spending globally, presenting significant growth opportunities in the cardiovascular devices market, which is projected to grow at a CAGR of nearly 5% from 2025 to 2030, driven by minimally invasive procedures, technological advancements, and AI integration [1] Company Analysis: Boston Scientific - Boston Scientific has a market capitalization of approximately $144 billion and specializes in a wide range of interventional medical devices [2] - The company is well-positioned in the $20 billion global MedSurg market, which is expected to grow at 7% through 2026-2028, with Boston Scientific aiming to exceed this growth [3] - Recent acquisitions, including Nalu Medical, Silk Road Medical, Intera Oncology, SoniVie, and Elutia, Inc., enhance its growth potential [3] - The Farapulse Pulsed Field Ablation System has gained FDA approval for expanded use in treating drug-refractory, symptomatic, persistent atrial fibrillation, contributing to its market share in electrophysiology [4] - The WATCHMAN business is rapidly growing, with favorable future prospects driven by new data and device launches [5] - Full-year net sales are expected to grow approximately 20% on a reported basis and 15.5% organically, with adjusted earnings anticipated between $3.02 and $3.04 per share, indicating a growth of 20% to 21% compared to 2024 [6] Company Analysis: Edwards Lifesciences - Edwards Lifesciences, valued at around $49 billion, focuses on structural heart innovation and reported a 12.6% year-over-year growth in Q3 2025 [7] - The company benefits from its RESILIA portfolio, with strong contributions from therapies like INSPIRIS, KONECT, and MITRIS, and is expanding its global access [8] - The introduction of the SAPIEN M3 is expected to enhance physician awareness and referrals, contributing to the growth of Transcatheter Mitral and Tricuspid Therapies, projected to reach $2 billion by 2030 [10] - The TAVR segment is experiencing growth due to renewed focus on treating aortic stenosis, with FDA approval for the SAPIEN 3 platform for severe AS patients without symptoms [11] - Edwards' updated sales growth guidance is at the high end of 9-10%, with adjusted EPS guidance raised to $2.56 to $2.62 [12] Comparative Analysis - Boston Scientific is viewed as the more compelling investment option due to its broad electrophysiology portfolio, strength in the WATCHMAN business, and impactful acquisitions [9] - Both companies have outperformed the broader medical sector, but Edwards has shown more resilience [16] - Boston Scientific trades at a forward price-to-sales ratio of 6.51X, which is lower than its historical median and Edwards' price-to-earnings ratio of 7.53X [16] - Analysts remain bullish on both companies, but Boston Scientific's attractive valuation makes it a more appealing choice currently [18]

Core Insights - Boston Scientific (BSX) shares have increased by 7% over the past 30 days, outperforming its industry and major competitors [1][8] - The company reported strong Q3 2025 performance, with operational sales and adjusted EPS each growing by 19% [3][8] - BSX has agreed to acquire Nalu Medical to enhance its chronic pain management portfolio [12][19] Performance Overview - BSX's stock performance has surpassed the industry's 0.9% gains, the Medical sector's 5.6% growth, and the S&P 500's 3% rise [1] - The stock closed at $104.98, just 4.1% below its 52-week high [3] - The company's Electrophysiology unit experienced a 63% year-over-year sales growth in Q3, driven by the Farapulse system [9] Business Segments - The Cardiovascular and MedSurg businesses contributed significantly to BSX's strong Q3 results [3][8] - The WATCHMAN business sales grew by 35% in Q3, with expectations for increased adoption of concomitant procedures [10] - Asia-Pacific sales grew by 17%, with strong performances in Japan and China [11] Strategic Initiatives - BSX is acquiring Nalu Medical for approximately $533 million to expand its neuromodulation offerings [12][13] - The company has been a strategic investor in Nalu since 2017 and expects Nalu to generate over $60 million in sales in 2025 [13] - BSX's revised 2025 outlook suggests approximately 20% net sales growth, exceeding previous guidance [16] Valuation Metrics - BSX shares are trading at a forward five-year price-to-sales (P/S) ratio of 7.08X, above the industry average [17]

Core Insights - Intuitive Surgical and Boston Scientific reported strong third-quarter results, highlighting their distinct growth strategies in the medtech sector [1][2] Financial Performance - Intuitive Surgical achieved third-quarter revenues of approximately $2.5 billion, reflecting a nearly 20% year-over-year increase, driven primarily by a 19% rise in da Vinci procedures and a 52% surge in Ion lung biopsy procedures [3][7] - Boston Scientific reported over $5 billion in revenues for the third quarter, marking around 15% organic growth, with an adjusted gross margin improvement to about 71% due to high-growth categories like electrophysiology [4][8] Growth Strategies - Intuitive Surgical focuses on deepening its surgical robotics franchise, with the da Vinci 5 system accounting for over half of its system placements, and expanding its Ion and SP platforms [10][16] - Boston Scientific adopts a diversified approach, leveraging multiple franchises such as WATCHMAN and FARAPULSE, and pursuing an active M&A strategy to enhance its product pipeline and market presence [12][17] Market Position and Valuation - Both companies hold a Zacks Rank 2 (Buy), with Boston Scientific viewed as more attractively valued compared to the industry, while Intuitive Surgical's valuation has declined but remains above the industry average [7][23][30] - Year-to-date, Intuitive Surgical shares have risen 4.5%, while Boston Scientific shares have gained 13%, reflecting the latter's stronger performance due to its diversified business model [18] Future Prospects - Intuitive Surgical's future growth will depend on the global adoption of the da Vinci 5 and the effectiveness of its new features, alongside its reliance on recurring revenues from procedures [19] - Boston Scientific's prospects hinge on its ability to scale multiple growth engines, particularly in electrophysiology and the WATCHMAN-ablation procedures, while managing the complexities of numerous product launches [20][22]

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Financial Data and Key Metrics Changes - In Q3 2025, total company operational sales grew 19%, and organic sales grew 15%, exceeding the guidance range of 12%-14% [6][22] - Q3 adjusted EPS was $0.75, reflecting a 19% increase and surpassing the guidance range of $0.70-$0.72 [6][22] - Adjusted operating margin for Q3 was 28%, with an expectation to expand full-year adjusted operating margin by approximately 100 basis points [6][23][26] Business Line Data and Key Metrics Changes - Urology sales grew 27% operationally and 5% organically, driven by international business and Global Stone Management [9] - Endoscopy grew 9%, with double-digit growth in key products [10] - Neuromodulation sales increased by 9%, supported by strong performance in the brain franchise [10] - Peripheral interventions sales grew 16% operationally and 6% organically, with low double-digit growth in the U.S. [11] - Cardiology sales grew 23%, with interventional cardiology therapy sales growing 3% [14] Market Data and Key Metrics Changes - U.S. operational sales grew 27%, while Europe, Middle East, and Africa (EMEA) declined 2% due to specific headwinds [7][8] - Asia-Pacific grew 17% operationally, led by strong growth in Japan and China [8] - WATCHMAN sales grew 35%, reflecting strong market penetration and adoption [15][16] Company Strategy and Development Direction - The company is focused on strategic tuck-in M&A in high-growth adjacencies, with the recent agreement to acquire Nalu Medical to expand into peripheral nerve pain [11][24] - The company aims for 10%+ average organic revenue growth from 2026 to 2028, with a target of 70%-80% annual free cash flow conversion [28] Management's Comments on Operating Environment and Future Outlook - Management expressed confidence in sustaining above-market growth, with expectations for continued strong performance in the cardiovascular and MedSurg segments [6][7] - The company anticipates improvements in backorders and operational performance in Europe in the fourth quarter [8] - Management remains optimistic about the growth potential of WATCHMAN and electrophysiology, projecting a 20% CAGR over the long-range plan [32][48] Other Important Information - The company experienced a backorder of approximately $30 million due to an ERP system upgrade, impacting various business lines [8][76] - The company expects to close the acquisition of Nalu Medical in the first half of 2026 [11][24] Q&A Session Summary Question: Is WATCHMAN a key growth driver? - Management confirmed that WATCHMAN is a significant growth driver, with expectations for continued market expansion and strong performance [32] Question: What is the outlook for the China market? - Management indicated that the China business is performing well, with expectations for double-digit growth despite price pressures [39] Question: How will the new product cycle impact CRM growth? - Management expressed confidence in the upcoming product cycle, including the Denali platform and EMPOWER leadless pacemaker, to strengthen CRM growth [86] Question: What are the dynamics outside EP and WATCHMAN? - Management highlighted strong growth in other divisions, including neuromodulation and endoscopy, and emphasized ongoing investments in these areas [58]