Dive Brief:

• Boston Scientific has set bullish growth targets for 2024 to 2026, according to analysts. The company is forecasting that a “dramatic shift” to pulsed field ablation will increase its organic revenues by 8% to 10% over the period.
• Analysts went into Boston Scientific’s investor day expecting 7% to 9% growth. Some analysts left the event speculating that Boston Scientific can exceed its 10% target after being convinced that PFA and left atrial appendage closure can power the company toward its goal.
• Boston Scientific forecast that the global atrial fibrillation ablation market will grow from $5 billion today to $8 billion in 2026 and $11 billion by 2028. PFA’s share of the market is predicted to rise from less than 5% today to 40% to 60% in 2026 and 60% to 80% in 2028.

Dive Insight:

Boston Scientific forecast an 8% to 10% organic sales compound annual growth rate after assessing its potential to lead two growing cardiovascular disease markets, PFA and LAAC. LAAC devices close up the left atrial appendage, preventing blood from pooling and clotting in the appendage.

In PFA, the company expects a rapid shift to new technology, and sees its Farapulse as the new standard of care in a market targeted by rivals such as Johnson & Johnson and Medtronic.

Talking at the investor day, Nick Spadea-Anello, global president for electrophysiology, forecast a “dramatic shift” that will see PFA dominate the AFib ablation treatment market in five years. “We sit on the precipice of huge growth,” Spadea-Anello said. That prediction reflects a belief that “the safety, the simplicity, the efficiency and efficacy” of PFA will make it the dominant energy source for AFib ablation.

Boston Scientific opted against providing a Farapulse market share outlook, but pitched its product as the future leader. Analysts at Stifel commented on preparations for the market launch, writing in a note to investors that “Boston Scientific management clearly indicated that Farapulse supply/availability will be ready and able to meet physician demand” after approval in the second half of next year.

Farapulse is a key plank of Boston Scientific’s growth forecast. The other plank, the LAAC device Watchman, is already on the market. Boston Scientific, after initially having a monopoly, faces competition from Abbott, but still sees a lot of room for growth. 

“We have been growing the therapy more and more every single month,” said Angelo De Rosa, vice president and general manager for Watchman. “The good news is ... that we are today only 10% of the penetration of the U.S. patients, according [to] current indication and current reimbursement. This is really what makes us confident that we can continue to grow significantly in this market in the more short term.”

In the longer term, Boston Scientific expects growth in the number of people with AFib and data from its clinical trials to drive Watchman sales. De Rosa predicted a mix of new indications and expanded reimbursement could quadruple the number of patients eligible for treatment with Watchman by 2030.

Boston Scientific identified additional growth drivers such as its Acurate neo2 transcatheter aortic valve replacement device and Ranger drug-coated balloon, both of which are expected to come to market next year. The medical device company forecast mid-teens growth in China despite near-term challenges such as value-based pricing and anti-corruption actions. The opportunities led analysts to predict Boston Scientific may beat its goal.

“Not that 8%-10% isn't impressive enough, we also believe the pipeline is rich and mature enough there could be upside to the range,” analysts at Truist wrote in a note to investors. “We think just the combination of PFA and Watchman alone could generate a significant portion of the incremental growth/sales to hit these implied 2026 [revenue] targets, and the pipeline is vast beyond these two products.”