Boston Scientific Targets Long-Term Growth as Key Businesses Face Pressure Through 2027

Key Points

• Boston Scientific is targeting sustained growth in its expanded interventional portfolio, with high-single-digit to double-digit growth beyond 2027 supported by a steady pipeline of product launches.
• Pulsed field ablation market share is expected to remain under pressure through 2027 as key product launches have been delayed: FARAWAVE Ultra is now expected in early 2028 and FARAFLEX in 2029.
• WATCHMAN also faces near-term competitive pressure, while management sees longer-term opportunity from new devices and potential coverage changes. Separately, Boston Scientific expects its TCAR business to recover and return to double-digit growth as supply and sales-force issues ease.

Boston Scientific NYSE: BSX executives said they expect durable growth across the company’s interventional portfolio, while acknowledging that its pulsed field ablation and WATCHMAN businesses face competitive challenges through 2027.

Lance Bates, executive vice president and president of interventional cardiology and vascular therapies, said the company’s breadth of products and planned launches support an aspiration for high-single-digit to double-digit growth in the business beyond 2027. Global Chief Medical Officer Ken Stein, meanwhile, said Boston Scientific expects its pulsed field ablation market share to remain under pressure until new products reach the market.

Interventional portfolio targets sustained growth

Beginning January 1, Bates will lead an expanded Interventional Therapies group encompassing interventional cardiology, vascular therapies and interventional oncology and embolization. Penumbra would also become part of the group once the transaction closes, he said.

Bates said the expanded organization could bring together research and development capabilities and allow products to reach physicians across multiple specialties. He emphasized that growth would come from numerous products rather than a single major launch.

The company aims to introduce an update to each key portfolio component every 12 to 18 months, Bates said. Planned 2027 introductions include intravascular ultrasound software with co-registration, another ultrasound catheter and Wolverine X, a version of its cutting balloon designed for improved deliverability. He also cited a planned full launch of the Ranger 035 drug-coated balloon for the superficial femoral artery.

On intravascular lithotripsy, Bates said Boston Scientific intends to compete on technology and clinical benefits rather than price or bundled contracts. He said the company’s optical laser approach allows physicians to select and aim emitters at calcium deposits. Early experience has shown fewer balloon exchanges during procedures, he said, though the company plans to discuss trial data and continue gathering evidence through registries.

Bates said it was reasonable to consider that drug-coated balloons could eventually be used in up to 30% of percutaneous coronary intervention procedures. He noted that in-stent restenosis accounts for about 10% of that market today and that adoption within that indication remains relatively early. Boston Scientific is conducting a randomized controlled trial and gathering real-world evidence to support expanded indications, he said.

TCAR recovery and product delays

Bates said Boston Scientific believes it is nearing the end of headwinds affecting its transcarotid artery revascularization, or TCAR, business. He cited previous sales-force disruption, manufacturing transition difficulties involving a neuroprotection device, and cyber issues that affected supply.

The sales force is now stable and supply-chain issues are being resolved, Bates said. He expects the business to return to double-digit growth.

Stein expressed frustration with delays to products in Boston Scientific’s pulsed field ablation portfolio. FARAWAVE Ultra has been moved to early 2028 and FARAFLEX to 2029, according to Stifel MedTech analyst Rick Wise, who moderated the discussion.

Stein said the delays did not stem from a single systemic issue. FARAWAVE Ultra needed more time for design enhancements, he said, while FARADIGM required additional patients in its first human-use study to optimize workflow. He also described some interactions with regulators and payers as more challenging.

Asked about FARAFLEX’s use of pulsed field ablation without radiofrequency energy, Stein said Boston Scientific is focused on improving its purpose-built catheter and ablation waveforms. Physicians needing radiofrequency treatment in limited cases can use a separate catheter, he said, though the company could develop a dual-energy device if the market demands one.

“Our share is going to continue to be under pressure until those products come out,” Stein said, adding that he hopes the new devices will improve Boston Scientific’s competitive position.

WATCHMAN faces near-term pressure

Stein said Boston Scientific needs to refocus the discussion around WATCHMAN, its left atrial appendage closure device, on patients with atrial fibrillation who cannot, will not or should not take long-term oral anticoagulants. He estimated that 30% to 40% of high-risk stroke patients with atrial fibrillation in the United States receive no protective therapy.

He acknowledged that Boston Scientific expects to lose WATCHMAN market share when a competitor introduces its next-generation device. He also said the population needing alternatives to current therapies is large enough for both WATCHMAN and Factor XI drugs to succeed over time.

Stein declined to provide guidance on when the pulsed field ablation and WATCHMAN franchises might improve. He said market dynamics would remain challenging through 2027, but pointed to potential new devices, labeling changes and a revision to the Centers for Medicare & Medicaid Services’ national coverage determination as reasons for longer-term optimism.

About Boston Scientific (NYSE:BSX)

Boston Scientific is a medical technology company that develops, manufactures and markets devices used in minimally invasive procedures across a range of medical specialties. Founded in 1979, the company is headquartered in Marlborough, Massachusetts. Its products support areas including cardiovascular care, endoscopy, urology and neuromodulation. They include catheter-based devices and therapies for conditions affecting the heart and blood vessels, as well as devices used in diagnostic and therapeutic procedures involving the digestive and urinary systems.

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