Boston Scientific (BSX) Q1 2025 earnings summary

Executive summary

• Q1 2025 net sales reached $4.663 billion, up 20.9% reported, 22.2% operational, and 18.2% organic year-over-year, exceeding guidance, driven by strong commercial execution and product launches, especially in Electrophysiology and Cardiology.

• Adjusted EPS grew 34% to $0.75, surpassing guidance; GAAP EPS was $0.45, with adjusted operating margin at 28.9%.

• Broad-based growth across business units and geographies, with notable strength in Cardiovascular, Electrophysiology, and Urology.

• Announced leadership transition: CFO Dan Brennan retiring, to be succeeded by Jon Monson.

• Completed acquisitions of Bolt Medical and Cortex, Inc.; announced agreements to acquire SoniVie Ltd. and Intera Oncology, with expected closings in Q2 2025.

Financial highlights

• Gross profit for Q1 2025 was $3.210 billion (68.8% margin), with operating income of $921 million, up from $675 million year-over-year.

• Adjusted gross margin improved 170 basis points to 71.5%; adjusted operating margin was 28.9%.

• Free cash flow for Q1 was $354 million; cash on hand at quarter-end was $725 million.

• Debt to adjusted EBITDA ratio stood at 2.2x as of March 31, 2025; total debt outstanding was $11.309 billion.

• SG&A expenses were $1.597 billion (34.2% of sales); R&D expenses were $443 million (9.5% of sales).

Outlook and guidance

• Raised full-year 2025 organic revenue growth guidance to 12%-14% and reported revenue growth to 15%-17%; adjusted EPS guidance increased to $2.87-$2.94.

• Q2 2025 net sales growth projected at 17.5%-19.5% reported and 13%-15% organic; adjusted EPS guidance $0.71-$0.73.

• Estimated FY 2025 free cash flow of $3.2 billion.

• Expect $200 million tariff impact in 2025, to be offset by sales upside and discretionary spend reductions.

• Management expects continued growth driven by innovation, acquisitions, and global expansion, but notes potential headwinds from inflation, supply chain, and regulatory changes.