Boston Scientific knows that nothing is simple in matters of the heart. The company makes medical supplies and devices used to diagnose and treat conditions in a variety of medical fields, with an emphasis on cardiovascular products and cardiac rhythm management. It also makes devices used for electrophysiology, endoscopy, pain management (neuromodulation), urology, and women's health. Its 13,000 products, made in 15 factories worldwide, include biopsy forceps, catheters, coronary and urethral stents, defibrillators, needles, and pacemakers. Boston Scientific markets its products in about 100 countries, mainly through its direct sales force, which is active in more than 40 countries.
While the US is still Boston Scientific's largest market, international sales have grown to make up about half of total sales. Boston Scientific has six manufacturing plants outside the US. These include three in Ireland, two in Costa Rica, and one in Puerto Rico. Other international facilities include physician training centers in France and Japan and research and development capabilities in Ireland.
Cardiovascular products, which are used in procedures that affect the heart and systems carrying blood, accounted for almost 45% of Boston Scientific's sales in 2011. The cardiovascular segment includes the company's interventional cardiology products (coronary stents, catheters, guidewires), which generate a third of sales, and peripheral intervention products (non-coronary stents), which bring in 10% of sales. Its cardiac rhythm management business, which accounts for more than 25% of the company's sales, manufactures pacemakers and implanted coronary defibrillators (ICDs) that keep hearts beating steadily.
Boston Scientific's other product segments accounted for almost 30% of sales, with endoscopy bringing in 16%, urology/women's health contributing 6%, neuromodulation adding 4%, and electrophysiology (including its Blazer line of ablation catheters for diagnosing and treating heart rate and rhythm disorders) generating 2%.
Sales and Marketing
Hospitals, clinics, outpatient facilities, and medical offices are the company's key customers, although in the US large group purchasing organizations (GPOs), hospital networks, and other buying groups make up a significant portion of its sales.
In 2011 Boston Scientific's revenues of $7.6 billion represented a 2% decrease from the $7.8 billion it achieved in 2010. The decline was mainly attributable to a drop in sales due to the divestiture of its neurovascular business, although this was offset by favorable foreign currency fluctuations that added $204 million to its net sales. Its reported net income for 2011, including charges related to acquisition, litigation, divestiture, restructuring, and other activities, was $441 million, an almost 60% increase over its $1 billion loss in 2010. Without the charges, its net income was $1 billion.
Strategically, the company makes select acquisitions to drive innovation and expand and diversify into additional areas and reaches of disease, as well as to expand geographically. The company is working to build its capabilities in such emerging markets as China, India, and Brazil by investing in infrastructure to support growth in these areas. Boston Scientific spends about 12% of its net sales on research and development each year to achieve its goal of leading global markets for less-invasive medical devices that address unmet patient needs. The company works to develop and sell novel products, services, and therapies that have proven economic value and deliver superior clinical outcomes; in 2011 it spent $895 million on R&D.
At the same time, Boston Scientific is keen on implementing measures to improve efficiencies to give it a competitive edge. These include restructuring initiatives, standardizing and automating some processes and activities, examining cost structures for its manufacturing plant network and R&D activities, leveraging its preferred vendors, and improving productivity. Additionally, it builds on its culture of leadership by providing integrated training and enrichment programs at every company level.
Boston Scientific has been steadily pruning what it determines to be noncore operations. In 2011 it sold its neurovascular division to orthopedics firm Stryker in a deal worth $1.5 billion. As part of the deal, Boston Scientific will gradually transition manufacturing duties to Stryker and will provide products to the buyer in the interim. The focus of the neurovascular division was on developing and marketing coils, stents, catheters, and other treatments for cerebral vascular conditions (such as brain aneurysms). In 2011 the division accounted for 2% of Boston Scientific's sales.
Despite years of litigation and more than $536 million in settement costs over malfunctions in its implantable cardioverter defibrillators (ICDs) gained through its purchase of Guidant, Boston Scientific has moved forward with its cardiac rhythm management business. It received approval in various global markets for several new defibrillation devices. The devices, however, still remain challenging: its COGNIS and TELIGEN ICDs were temporarily pulled off of the US market in 2010 due to an oversight in paperwork submitted to the FDA. A further drag on ICDs emerged in 2011 when an article in the Journal of the American Medical Association suggested that the devices have been overused. While Boston Scientific initially shrugged off the study, within a few months, as doctors began rethinking their usage, the company acknowledged that the cardiac rhythm management market was increasingly challenging.
Mergers and Acquisitions
Among Boston Scientific's major acquisitions are its mid-2012 purchase of private device maker Cameron Health in a deal worth up to $1.3 billion. The deal caps a 10-year relationship in which Boston Scientific invested in Cameron Health's efforts to research, develop, and commercialize the world's first and only subcutaneous implantable cardioverter defibrillator, the S-ICD system, which helps in the event of sudden cardiac arrest. The S-ICD system is commercially available outside of the US. Now it adds that system to its already strong arrhythmia management product portfolio. – less