ICU Medical (ICUI) Q4 2025 earnings summary

Executive summary

• Q4 2025 revenue was $536M–$540.7M, down 14% year-over-year due to IV Solutions JV deconsolidation; full-year 2025 revenue was $2.21B–$2.23B, with 5% organic growth.

• Both consumables and systems businesses achieved record operational revenue quarters, with consumables up 6% and infusion systems up 3% in Q4.

• Integration of Smiths Medical sites and ERP systems largely completed, supporting future synergies.

• FDA warning letter closure and progress on new 510(k) clearances for key pump products.

• IV Solutions business was included in consolidated revenue until May 1, 2025, after which it was excluded due to the joint venture formation.

Financial highlights

• Q4 2025 gross margin was 40.5% (adjusted), GAAP gross margin 38%; adjusted EBITDA was $98M–$98.2M, down 7% YoY due to JV deconsolidation and tariffs.

• Adjusted EPS for Q4 was $1.91, down 9% YoY; free cash flow for Q4 was $44M; full-year free cash flow was $100M–$125.4M.

• Ended Q4 with $1.3B debt, $308M cash, and net debt just below $1B.

• Consumables segment posted $1,109M in 2025, up 7% year-over-year organically.

• Oncology Systems revenue grew 5% year-over-year to $684M in 2025.

Outlook and guidance

• 2026 organic revenue growth expected in low- to mid-single digits; mid-single digits for consumables and infusion systems, flat to slightly down for vital care.

• Adjusted gross margin for 2026 guided at ~41%, improving through the year as integration benefits are realized.

• Adjusted EBITDA for 2026 expected at $400M–$430M; adjusted EPS $7.75–$8.45; GAAP net income projected at $26M–$44M.

• Free cash flow to improve in 2026, weighted to the back half as integration spending declines.

• CapEx for 2026 is expected to range from $85M to $100M.