BOSTON SCIENTIFIC 2020 ANNUAL REPORT BOSTON
2020 Annual Report
Boston Scientific Corporation 300 Boston Scientific Way Marlborough, MA 01752-1234 bostonscientific.com
© 2021 Boston Scientific Corporation or its affiliates. All rights reserved. AR2020
23006_031221_10k_Cover.indd 1 3/15/21 1:02 PM Board of Directors Executive Officers Stockholder Information Nelda J. Connors 2,4 Daniel J. Brennan Stock Listing Certifications of the Chief Founder and Chief Executive Vice President Boston Scientific Corporation Executive Officer and Chief Executive Officer, Pine and Chief Financial Officer common stock is traded on the Financial Officer certifying the Grove Holdings, LLC NYSE under the symbol “BSX.” accuracy of the Company’s Arthur C. Butcher public disclosures have been 1,4 Executive Vice President Charles J. Dockendorff Transfer Agent filed with the Securities and and President, Asia Pacific Former Executive Vice Inquiries concerning the Exchange Commission as President and Chief transfer or exchange of Wendy Carruthers exhibits to the Company’s Financial Officer, shares, lost stock certificates, Senior Vice President, Annual Report on Form Covidien plc duplicate mailings, or changes Human Resources 10-K for the year ended of address should be directed Yoshiaki Fujimori 4 December 31, 2020. Jodi Euerle Eddy to the Company’s Transfer Senior Executive Advisor Senior Vice President and Agent at: Copies of these reports are of Japan, CVC Capital Chief Information and also available by directing Partners Computershare Inc. Digital Officer requests to: P.O. Box 30170 Donna A. James 2,3 Investor Relations Joseph M. Fitzgerald College Station, TX 77842-3170 Founder, President Boston Scientific Corporation Executive Vice President and Managing Director, Shareholder website: 300 Boston Scientific Way and President, Interventional Lardon & Associates, LLC www.computershare.com/ Marlborough, MA 01752-1234 Cardiology investor 508-683-4000 Edward J. Ludwig 2 Edward F. Mackey 508-647-2200 (Facsimile) Former Chief Executive Shareholder online inquiries: Executive Vice President, [email protected] Officer and Chairman, Becton, https://www-us.computer Operations Dickinson and Company share.com/investor/contact Investor Information Requests Investors, stockholders and 2,3 Michael F. Mahoney Stephen P. MacMillan Chairman of the Board; Independent Registered security analysts seeking Chairman, President and President and Chief Public Accounting Firm information about Boston Chief Executive Officer, Ernst & Young LLP Executive Officer Scientific should refer to Hologic, Inc. Boston, Massachusetts our website at Professor Ian T. Meredith, AM www.bostonscientific.com Michael F. Mahoney Executive Vice President and Annual Meeting Chairman of the Board; The 2021 annual meeting or contact Investor Relations Global Chief Medical Officer President and Chief of stockholders will take at 508-683-4000, or by email at Executive Officer Jeffrey B. Mirviss place on Thursday, May 6, 2021, [email protected] Executive Vice President beginning at 8:00 a.m. Eastern 1,3 David J. Roux and President, Peripheral Time. The annual meeting Co-Founder, Co-Managing Corporate Headquarters Interventions will be held in a virtual format Partner, BayPine Capital Boston Scientific Corporation only and can be accessed at 300 Boston Scientific Way Maulik Nanavaty 1,4 https://www.virtualsharehold Marlborough, MA 01752-1234 John E. Sununu Senior Vice President and Former U.S. Senator ermeeting.com/BSX2021. 508-683-4000 President, Neuromodulation Ellen M. Zane 1,3 Other Information Investor Relations Facsimile: Scott Olson CEO Emeritus, Tufts Copies of the Company’s 508-647-2200 Senior Vice President Medical Center and Annual Report on Form 10-K, and President, Rhythm Tufts Children's Hospital Quarterly Reports on Form www.bostonscientific.com Management 10-Q, Current Reports on Form Information on or connected David A. Pierce 8-K and amendments to those to our website (or the website Information is accurate as of March 1, 2021. reports are available free of 1 Member of the Audit Committee Executive Vice President of any third party) referenced 2 Member of the Executive Compensation and President, MedSurg; charge on our website at in this Annual Report is in and Human Resources Committee and President, Endoscopy www.bostonscientific.com. addition to and not a part of 3 Member of the Nominating and Our Corporate Governance Governance Committee or incorporated by reference Desiree Ralls-Morrison 4 Member of the Risk Committee Guidelines and our Code of into this Annual Report. Senior Vice President, Conduct — which applies to Such additional information General Counsel and all our directors, officers and speaks as of the date thereof Corporate Secretary employees, including our and is not intended to be Chief Executive Officer and Meghan Scanlon confirmed or updated by Chief Financial Officer — are Senior Vice President reference to it herein. Boston also available on our website. and President, Urology Scientific disclaims any and Pelvic Health liability or responsibility for or endorsement of the John B. Sorenson information on or connected Senior Vice President, to the website of a third party. Manufacturing and Supply Chain Eric Thépaut Executive Vice President and President, Europe, Middle East and Africa
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Dear Stockholders: Over the last year, the global pandemic, political strife and racial injustice have tested us — and our business — as never before. These challenges, however, have not derailed Boston Scientific from our mission to transform lives through medical solutions that improve the health of patients around the world.
Throughout 2020, our teams worked nimbly and quickly to support generated revenue of $219 million. Our worldwide performance customers, manage costs and put strategies in place to navigate reflected the effects of COVID-19, with declines in operational1 through uncertainty. We enhanced our digital capabilities to serve revenue of 9.7 percent in the United States, 8.4 percent in EMEA, customers in new ways, launched innovative products and touched 7.1 percent in APAC, and 15.2 percent in Latin America and Canada the lives of close to 30 million patients. We contributed more compared to 2019. Annual sales in Emerging Markets5 countries than $18 million in aid to global COVID-19 relief efforts, through were also affected, declining 9.2 percent on an operational1 basis. monetary and supply donations and by volunteering and providing engineering and manufacturing expertise and resources. We also Our adjusted operating margin6 for the full year was 19.3 percent, strengthened our commitment to diversity, equity and inclusion with adjusted earnings per share6 of $0.96, compared to $1.58 and took action to confront racism and advance social justice. a year ago. This reflects the impact of reduced procedure volumes due to COVID-19 as well as the discontinuation of the The unmet needs in healthcare are great, and we have much work LOTUS Edge™ Aortic Valve System and impact from the shift to the to do, but I’m proud of our successes and know they have been consignment model for the WATCHMAN franchise. Despite these possible because of the incredible winning spirit of our 38,000 challenges, we generated $2 billion in adjusted free cash flow,7 employees and the values that define and guide our company. with free cash flow8 of $1.1 billion. As a result of the agility and resilience our teams have shown, our business remains strong, and we believe we are well-positioned With our innovative pipeline, strong commercial presence and to return to consistent growth when the pandemic subsides and ongoing expansion into higher growth markets, we continue to medical procedure volumes resume. execute against our strategic plan objectives and drive towards ex-COVID-199 financial goals for 6-8% organic2 sales growth, expanded adjusted operating margins6 and double-digit adjusted 2020 Business Results earnings per share6 growth. We believe this momentum, combined The decline and deferral of elective procedures due to the with our ability to generate and deploy strong free cash flow, pandemic affected our revenue and earnings. As a result, our positions Boston Scientific well to create future shareholder value. 2020 financials are an exception to what has been a nearly six-year trend of excellent performance. Positioned for Growth Our full-year net sales in 2020 were $9.913 billion. This represents Boston Scientific products are used to help diagnose or treat declines of 7.8 percent on an operational1 basis and 11.3 percent complex diseases and conditions across multiple fields: cardio- on an organic2 basis compared to 2019, both of which include vascular, respiratory, digestive, neurological, urological and pelvic a 170-basis point impact associated with the conversion of U.S. health. By deepening our portfolio in these areas, our category WATCHMAN™ customers to a consignment inventory model and leadership strategy creates value for patients, physicians and transition to the next-generation WATCHMAN FLX™ Left Atrial payors. We believe our strong balance sheet and businesses Appendage Closure (LAAC) Device. Organic2 revenue declined by will enable us to continue to pursue growth and expand our 6.7 percent in MedSurg , by 13.4 percent in Rhythm and Neuro, presence in new markets and regions and make our technologies and by 13.1 percent in Cardiovascular.3 Outside of our three accessible to more people in need. As of December 31, 2020, reporting segments, our Specialty Pharmaceuticals4 business we had $1.7 billion in cash on hand, which will enable us to continue to make strategic, growth-enhancing investments.
1 Operational revenue growth rates are non-GAAP measures that exclude the impact of foreign currency fluctuations; see non-GAAP reconciliations on pages 6 and 7. 2 Organic revenue growth rates are non-GAAP measures that exclude the impact of foreign currency fluctuations and net sales from recent acquisitions and divestitures with less than a full year of comparable net sales. See non-GAAP reconciliations on pages 6 and 7. 3 We have three reportable segments comprised of Medical Surgical (MedSurg), Rhythm and Neuro, and Cardiovascular, which represent an aggregation of our operating segments that generate revenues from the sale of medical devices (Medical Devices). We have included the results of BTG’s Interventional Medicine business in our Peripheral Interventions operating segment since the date of acquisition. 4 As part of our acquisition of BTG, we acquired a specialty pharmaceuticals business (Specialty Pharmaceuticals), a stand-alone operating segment presented alongside our Medical Device reportable segments. On March 1, 2021, we completed the sale of the Specialty Pharmaceuticals business to Stark International Lux S.A.R.L. and SERB SAS, affiliates of SERB, for a purchase price of $800 million. 5 We define Emerging Markets as including certain countries that we believe have strong growth potential based on their economic conditions, healthcare sectors, and our global capabilities in our Medical Devices business. Currently, we include 20 countries in our definition of Emerging Markets. 6 Adjusted operating margin and adjusted earnings per share and related growth rates are non-GAAP measures that exclude the impacts of certain charges (credits) which may include amortization expense; goodwill and intangible asset impairment charges; acquisition/divestiture-related net charges and credits; restructuring and restructuring-related net charges and credits; certain litigation-related net charges and credits, investment gains and losses, EU MDR implementation charges, debt extinguishment charges, discrete tax items and deferred tax expenses (benefits). See non-GAAP reconciliations on pages 6 and 7. 7 Adjusted free cash flow is a non-GAAP measure that excludes net purchases of property, plant and equipment, as well as the cash component of certain charges (credits) that are excluded from adjusted net income, in addition to any cash tax benefits of such charges. Further, we exclude from this measure tax settlement payments that relate to prior periods. The GAAP measure that is most directly comparable to adjusted free cash flow is cash provided by operating activities. See non-GAAP reconciliations on pages 6 and 7. 8 Free cash flow is a non-GAAP measure that excludes net purchases of property, plant and equipment. The GAAP measure that is most directly comparable to adjusted free cash flow is cash provided by operating activities. See non-GAAP reconciliations on pages 6 and 7. 9 Growth goals ex-COVID-19 represent comparisons between time periods in which results are not materially impacted by the COVID-19 pandemic.
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Our acquisition of Lumenis LTD, which is expected to close in the obstruction and superficial venous disease. We are seeing second half of 2021, positions Boston Scientific to accelerate the significant clinical interest in our EKOS® Endovascular System, delivery of our stone management offerings to more urologists which received additional reimbursement from the U.S. Centers and expand our global footprint throughout Europe and Asia. for Medicare and Medicaid Services (CMS). These technologies complement our arterial portfolio, which is showing strong We are pursuing opportunities to advance access to healthcare momentum. The Eluvia™ Drug-Eluting Vascular Stent System in Emerging Markets.5 In China, we target a return to double-digit received additional CMS reimbursement in the United States growth in 2021 and are focused on increasing access to our products and launched in China. The Ranger™ Drug-Coated Balloon was and technologies with the opening of our Institute for Advancing also approved by the U.S. Food and Drug Administration (FDA), Science (IAS) in Chengdu. The new facility allows us to combine our enabling us to offer physicians the first peripheral artery global resources with the expertise of local partners to accelerate disease product portfolio with both a drug-eluting stent the development of and access to healthcare in western China. and a drug-coated balloon.
We also continue to expand our global digital capabilities. A DELIVERING CARDIAC DIAGNOSTICS, THERAPIES AND SERVICES silver lining of adapting to the COVID-19 pandemic has been the Our Cardiac Rhythm Management business launched the LUX-Dx™ company’s accelerated execution of digital and virtual solutions Insertable Cardiac Monitor (ICM) System, a long-term diagnostic that in healthcare and greater use of remote monitoring technology is implanted in patients to detect cardiac arrhythmias. The device in many regions. We’ve increased our investments in customer builds on the successful HeartLogic™ Heart Failure Diagnostic and patient engagement, medical education, clinical trial remote (featured within our RESONATE™ family of implantable cardioverter case support, sales force enablement and mobile ordering and defibrillator and cardiac resynchronization therapy defibrillator solutions. We consider these platforms a catalyst for growth and systems). Through the acquisition of Preventice Solutions, Inc., structural costs savings over time. we are expanding our rhythm management diagnostic portfolio to include mobile cardiac health solutions and services, ranging from ambulatory cardiac monitors — including short- and long- Addressing Critical Needs Through term Holter monitors — to cardiac event monitors and mobile Meaningful Innovation cardiac telemetry. Our research and development teams surmount the limitations Data from pacemakers and defibrillators monitored remotely by of current technology and address healthcare challenges with our LATITUDE™ Home Monitoring System are featured in a new practical products tailored to customer needs, which includes study underway to better understand how COVID-19 affects people continuously developing improvements to our devices and with heart conditions or chronic illnesses and how to improve their identifying unmet clinical needs for new product opportunities. healthcare. Collaborating with Yale New Haven Hospital’s Center Our approach is to source innovation by applying a combination for Outcomes Research & Evaluation (CORE), we aim to detect of organic research, collaborations and acquisitions, as well as and anticipate which patients will need critical resources, such strategic investments in our venture portfolio. as intensive care.
For the fourth consecutive year, Boston Scientific was named In Electrophysiology, our teams are building a comprehensive one of the Top 100 Global Innovators by Clarivate Analytics. portfolio of technologies to advance the treatment of patients who We fund innovation at the high end of our peer group, investing have atrial fibrillation. We launched the POLARx™ Cryoablation more than $1 billion annually in research and development. System in Europe and received regulatory approval and reimburse- Despite the challenges of the pandemic, we continued to ment for the INTELLANAV STABLEPOINT™ Ablation Catheter innovate, with 69 product launches, 119 global clinical trials, enabled with DIRECTSENSE™ Technology in Japan. We also numerous regulatory approvals and improved payment models secured an exclusive option to acquire Farapulse, Inc., a private that are bringing much-needed solutions to customers across company developing a pulsed field ablation system that uses an the medical specialties we serve. electric field rather than thermal energy to treat atrial fibrillation and other cardiac arrhythmias. These milestones demonstrate TACKLING CHALLENGING DISEASES WITH a commitment to our category leadership strategy and enable VASCULAR INTERVENTIONAL TECHNOLOGY physicians to select therapies based on clinical preferences and We support physicians who treat some of the most challenging individual patient needs. diseases with comprehensive technologies backed by clinical evidence. With the completion of the integration of BTG plc., PERSONALIZING NEUROMODULATION THERAPY we have a broad interventional oncology portfolio that includes Our Neuromodulation portfolio of innovations and product therapeutic technologies for patients suffering from liver and refinements enables physicians to precisely personalize therapy kidney cancers. Our vascular portfolio includes products that for each patient. Our next-generation WaveWriter Alpha™ treat deep vein thrombosis, pulmonary embolism, deep venous portfolio of Spinal Cord Stimulator (SCS) Systems launched in
5 We define Emerging Markets as including certain countries that we believe have strong growth potential based on their economic conditions, healthcare sectors, and our global capabilities in our Medical Devices business. Currently, we include 20 countries in our definition of Emerging Markets.
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Europe last year and was introduced in the U.S. market early this of reusable scopes. As the leading innovator in this space, we year. The technology helps treat patients suffering from chronic, initiated a global launch of the SpyGlass™ Discover Digital intractable pain and addresses a critical need for effective, drug- Catheter, the first single-use scope designed for surgeons that free pain management options. Our most advanced deep brain streamlines diagnostic and therapeutic procedures in the stimulation (DBS) technology, the Vercise Genus™ DBS System, pancreaticobiliary system, including laparoscopic gallbladder received FDA approval early in 2021, following 2020 CE Mark procedures. We also received CMS approval for a transitional approval and introduction in Europe. Deep brain stimulation pass-through payment category for single-use endoscopes, treats the symptoms of movement disorders such as Parkinson's including our EXALT™ Model D Single-Use Duodenoscope, the disease by targeting and stimulating specific regions of the brain world’s first single-use duodenoscope. The approval of this new with mild electrical impulses. The Vercise Genus technology is payment category helps ensure healthcare providers have access designed to provide precision and selectivity so that physicians to EXALT Model D at a time when awareness is heightened for can personalize care and provide optimal symptom relief. the need to eliminate infection risk among patients, physicians and hospital staff. We also anticipate introducing the EXALT ADVANCING SCIENCE AND OUTCOMES WITH Model B Single-Use Bronchoscope in the second half of 2021. STRUCTURAL HEART TECHNOLOGIES More than 150,000 patients diagnosed with non-valvular atrial EXPANDING OUR OFFERINGS IN MEN’S HEALTH fibrillation (AF) have been treated with our WATCHMAN™ Left We applied our pursuit of innovation to reduce the side effects Atrial Appendage Closure (LAAC) Device to reduce their risk of of prostate radiation therapy with our next-generation SpaceOAR stroke. In 2020, we received regulatory approval from the FDA for Vue™ Hydrogel, which can be visualized during computed our next-generation device — WATCHMAN FLX — which is designed tomography scans for radiation treatment planning, as opposed to offer increased ease-of-use for physicians and improved to more costly magnetic resonance imaging. We also continued procedural outcomes for patients, including reduced complication to build a strong body of clinical evidence supporting Rezūm™ risk and healing time. The new device also received Japanese Water Vapor Therapy, a minimally invasive treatment for benign Pharmaceuticals and Medical Devices Agency approval and prostatic hyperplasia. New five-year clinical data, presented at Japanese National Health Insurance reimbursement approval. the American Urological Association annual meeting in April, demonstrated the long-term durability of treatment with the Several clinical studies are underway to document the safety Rezūm System. More than 70,000 patients worldwide have and efficacy of our structural heart devices, including: been successfully treated with the device. And reimbursement for the therapy has increased significantly, covering approximately The global CHAMPION-AF trial, which compares the WATCHMAN 223 million patients in the United States. FLX device against best-in-class pharmacological therapy for stroke prevention, is evaluating the technology as a first-line therapy for patients who can tolerate oral anticoagulants. A Focused On Our Mission and Values positive study outcome has the potential to change clinical We continue to live our values with a strong commitment to practice and make the device more accessible to patients who sustainable, equitable and inclusive business practices. In doing would benefit from a one-time procedural alternative to the so, our employees have helped Boston Scientific achieve numerous long-term use of blood thinners and related side effects. recognitions, including being named among Forbes America’s Most JUST Companies, Newsweek America’s Most Responsible
The global PROTECTED TAVR randomized clinical trial, which Companies, and FORTUNE World’s Most Admired Companies. evaluates 3,000 patients undergoing transcatheter aortic valve replacement (TAVR) with or without our SENTINEL™ Cerebral CARING FOR COMMUNITIES: COVID-19 RELIEF SUPPORT Protection System. The trial studies the efficacy of the device Throughout the COVID-19 pandemic, our priority has been the in preventing stroke during TAVR procedures, including among health and safety of our employees, as well as our customers and patients who are at low risk of stroke. their patients. Around the world, our employees worked tirelessly to ensure that our life-changing devices and therapies were
The ACURATE investigational device exemption clinical trial is available when needed. evaluating the safety and effectiveness of the ACURATE neo2™ Valve System for TAVR procedures in patients with aortic We stepped in to support communities in need. For the most stenosis in the extreme, high, and intermediate risk categories. vulnerable in our communities, we provided direct financial The device received CE Mark and launched in Europe in 2020. contributions to local and global non-profit organizations, including It is not available for sale in the United States. Project HOPE and the International Federation of Red Cross and Red Crescent Societies. We utilized our supply chain capabilities to ELIMINATING REPROCESSING RISKS WITH SINGLE-USE ENDOSCOPES help source and produce components for commercial ventilators Single-use endoscopes don’t require reprocessing, which eliminates for use in treating patients suffering from COVID-19 and to enable the risk of potential infection from ineffective reprocessing — as well increased global production of transportable ventilators. as myriad hassles associated with the scheduling and maintenance
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We also found innovative ways to address the urgent demand for from cardiovascular disease. In 2020, we expanded Close the Gap, personal protective equipment and ventilators. Our employees launching a public service advertising campaign to healthcare volunteered to assemble and donate over one million face shields providers to increase awareness of health disparities and promote for healthcare providers. Working with the University of Minnesota resources that will help these care providers address the gaps. Bakken Medical Devices Center and others in the industry, we helped bring the Coventor to market, an emergency resuscitator that can We’re also focused on increasing diverse representation among be used when traditional ventilators are not available. In collabora- healthcare professionals through scholarships for Black graduate- tion with an international coalition of medical experts, clinicians level healthcare students, and we’re funding primary and and industry leaders, we designed and developed the Pneumask™ secondary school grants to encourage the next generation to Face Shield, a reusable full-face mask that has been authorized by achieve in Science, Technology, Engineering and Math (STEM). the FDA for use as personal protective equipment in clinical settings. ADOPTING ENVIRONMENTALLY SUSTAINABLE BUSINESS PRACTICES BUILDING A MORE DIVERSE, EQUITABLE AND INCLUSIVE Fulfilling our mission also carries a responsibility to protect and WORKPLACE AND SOCIETY aid the health of our planet. That’s why we have set aggressive Our ability to fulfill our mission depends on having a team with environmental goals. In 2017 we committed to achieving carbon diverse ideas, people and talent. We are committed to doing our neutrality — net zero carbon emissions — across our manufacturing part to help address the root causes of racism and build a more and key distribution sites by 2030. We’ve made significant progress equitable, inclusive society — within Boston Scientific and within toward that goal, reducing our carbon footprint by 50 percent. We our communities. This requires deliberate and consistent effort. expect to source or generate 100 percent of our electricity from renewable energy sources by 2024. Forty-two percent of our nine Three years ago, we publicly shared our goals to improve diversity, million square feet of global real estate is independently certified equity and inclusion within our workforce. We have made great for energy efficiency by industry-leading programs. To support strides, but we have more to do. In 2020, we updated our goals: the environmental sustainability of our operations, 16 of our sites to increase representation of women and multicultural talent in are certified to an Environmental Management System. Although mid-management roles to at least 43 percent and 23 percent Boston Scientific is already a low-intensity water user, we’ve respectively within three years, and to continue to be a top 10 reduced water usage by 23 percent over the last decade, and percent globally recognized leader for workplace inclusion. Our we’ve diverted 94 percent of landfill solid waste through recycling, collaboration with partners including historically Black colleges plastic segregation, redesigning packaging and other environmen- and universities, the Human Rights Campaign, Disability:IN, the tally responsible measures. As evidence of our progress, we were Hispanic Association on Corporate Responsibility and the Society named to the 2020 Dow Jones Sustainability Index North America, of Women Engineers helps support hiring and development of one of the most prestigious benchmarks for corporate responsibility. talent from underrepresented groups. We also invest in ally and mentorship initiatives to support women and multicultural leaders. All employees participate in unconscious bias training, and we’ve Looking to the Future increased training for leaders to foster an understanding of micro- I continue to be inspired and optimistic about the future of our aggressions, the history of racism and how to champion diversity, world and the future of Boston Scientific. The challenges ahead equity and inclusion. Four of our employees were selected to join are great, but the opportunities are far greater. We have a robust the inaugural CEO Action for Racial Equity Fellowship, transitioning portfolio, a strong pipeline and talented employees equipped from their Boston Scientific jobs to help identify, develop and with the right resources to address ever-changing customer needs. promote public policies and corporate engagement strategies Our response to COVID-19 demonstrates our agility, and as the to address systemic racism and social injustice. I am honored to impact of the pandemic wanes, we will be a stronger company. support the fellows as one of 20 CEOs on the CEO Action for Racial Equity Governing Committee. I am grateful for the passion, commitment and talent of our global team and for the patients and customers who place their trust in Our external strategy includes a $3.5 million multi-year investment our devices and therapies each and every day. On behalf of all of to help combat racism in the United States, including philanthropic us at Boston Scientific, I want to thank our Board of Directors for commitments focused on government and legislative change, their service, and you, our stockholders, for your support. Working community support, economic empowerment, education and together, we will continue to advance science for life to improve healthcare disparities. The challenges of COVID-19, disproportion- the health of patients around the world. ately affecting communities of color, and the racial injustice and social unrest we experienced in 2020 underscore just how critical Sincerely, this work is.
Through our Close the Gap health equity program, Boston Scientific has had a longstanding commitment to address Mike Mahoney, treatment disparities among women and minorities who suffer Chairman, President and Chief Executive Officer March 17, 2021
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Operational Percent of Reported Growth Consolidated 2020 Net Sales by Region (dollars in millions) Net Sales (Decline)1 Net Sales (%) U.S. $5,508 (9.7)% 55.6% EMEA (Europe, Middle East and Africa) 2,097 (8.4)% 21.2% APAC (Asia-Pacific) 1,781 (7.1)% 18.0% LACA (Latin America and Canada) 307 (15.2)% 3.1% Medical Devices2 9,694 (9.1)% 97.8% Specialty Pharmaceuticals3 219 n/a 2.2% Net Sales $ 9,913 (7.8)% 100.0%
Operational Percent of Reported Growth Consolidated 2020 Net Sales by Product Category (dollars in millions) Net Sales (Decline)1 Net Sales (%) MEDSURG Endoscopy $ 1,780 (6.3)% 18.0% $350 Urology and Pelvic Health 1,286 (9.0)% 13.0% 300 RHYTHM AND NEURO Cardiac Rhythm Management 1,704 (12.4)% 17.2% Electrophysiology 287 (13.5)% 2.9% Neuromodulation 761 (13.0)% 7.7% CARDIOVASCULAR Interventional Cardiology 2,299 (18.2)% 23.2% $100 200 Peripheral Interventions 1,577 13.1 % 15.9% Medical Devices2 9,694 (9.1)% 97.8% 2014 2015 2016 2017 2018 2019 Specialty Pharmaceuticals3 219 n/a 2.2% Net Sales 100$ 9,913 (7.8)% 100.0% 350
Operational Adjusted Adjusted Earnings 0 Comparison of Revenue Growth Operating Per Share Growth 5-Year Cumulative (Decline)1,4 Margin5 (Decline)5,7 Total Return* 0 (11%) (8%) 19.3% (39%) — 300 * $100 invested on 12/31/15 in stock or index, including reinvestment of dividends. Fiscal year ending December 31. 7% 11% 12 26.1% 8% 13%
10
7% 8% 8 25.5% 17% 11% 20 30 6 15
4 10 25 200 2 5 19 18 19 18 0 0 20 -2 -5 20 20 -4 -10 15 -6 -15 -8 100-20 10 -10 -25
-12 -30 5 -35 15 16 17 18 19 20 20 19 18 -40 0 Operational revenue growth Adjusted earnings per share growth5 Boston Scientific Corporation © 2021 Standard & Poor’s, a division of Organic revenue growth Adjusted earnings per share growth, S&P Health Care Equipment S&P Global. All rights reserved. excluding 2018 net tax benefit7 S&P 500
1 Operational revenue growth rates are non-GAAP measures that exclude the impact of foreign currency fluctuations; see non-GAAP reconciliations on pages 6 and 7. 2 We have three reportable segments comprised of Medical Surgical (MedSurg), Rhythm and Neuro, and Cardiovascular, which represent an aggregation of our operating segments that generate revenues from the sale of medical devices (Medical Devices). We have included the results of BTG’s Interventional Medicine business in our Peripheral Interventions operating segment since the date of acquisition. 3 As part of our acquisition of BTG, we acquired a specialty pharmaceuticals business (Specialty Pharmaceuticals), a stand-alone operating segment presented alongside our Medical Device reportable segments. On March 1, 2021, we completed the sale of the Specialty Pharmaceuticals business to Stark International Lux S.A.R.L. and SERB SAS, affiliates of SERB, for a purchase price of $800 million. 4 Organic revenue growth rates are non-GAAP measures that exclude the impact of foreign currency fluctuations and net sales from recent acquisitions and divestitures with less than a full year of comparable net sales. See non-GAAP reconciliations on pages 6 and 7. 5 Adjusted operating margin and adjusted earnings per share and related growth rates are non-GAAP measures that exclude the impacts of certain charges (credits) which may include amortization expense; goodwill and intangible asset impairment charges; acquisition/divestiture-related net charges and credits; restructuring and restructuring-related net charges and credits; certain litigation-related net charges and credits, investment gains and losses, EU MDR implementation charges, debt extinguishment charges, discrete tax items and deferred tax expenses (benefits). See non-GAAP reconciliations on pages 6 and 7. 6 We define Emerging Markets as including certain countries that we believe have strong growth potential based on their economic conditions, healthcare sectors, and our global capabilities in our Medical Devices business. Currently, we include 20 countries in our definition of Emerging Markets. 7 Full year 2018 adjusted earnings per share was $1.47, which includes a $0.07 net tax benefit for the year. Excluding this net tax benefit of $0.07, our 2018 adjusted earnings per share grew 11 percent. 2019 adjusted EPS growth including the aforementioned 2018 net tax benefit is 8 percent and normalized for the 2018 net tax benefit is 13 percent.
Percentages are calculated using unrounded numbers and may not calculate precisely due to rounding. Amounts may not add due to rounding.
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This Annual Report contains forward-looking statements within the meaning of the federal securities laws. See the discussion under “Safe Harbor for Forward-Looking Statements” in the Annual Report on Form 10-K for the year ended December 31, 2020, for matters to be considered in this regard. In addition, please see our Annual Report on Form 10-K for a description of our Non-GAAP adjustments and the reasons for excluding each item.
Year Ended December 31, 5-Year Net Sales Growth (Decline) 2020 2019 2018 2017 2016 Average Net sales growth (decline), as reported (7.7)% 9.3 % 8.6 % 7.9 % 12 % 6 % Less: Impact of foreign currency fluctuations 0.1 % (1.8)% 0.6 % 0.1 % — % (0)% Net sales growth (decline), operational (7.8)% 11.1 % 8.0 % 7.8 % 12 % 6 % Less: Impact of certain acquisitions and divestitures 3.5 % 3.8 % 0.8 % 1.2 % 2 % 2 % Net sales growth (decline), organic (11.3)% 7.3 % 7.2 % 6.6 % 10 % 4 %
Year Ended December 31, 2020 Net Sales Growth (Decline) Rhythm of Reportable Segments MedSurg and Neuro Cardiovascular Net sales growth (decline), as reported (7.3)% (12.4)% (7.9)% Less: Impact of foreign currency fluctuations 0.2 % 0.3 % — % Net sales growth (decline), operational (7.5)% (12.7)% (7.9)% Less: Impact of certain acquisitions and divestitures (0.7)% 0.8 % 5.2 % Net sales growth (decline), organic (6.7)% (13.4)% (13.1)%
Year Ended December 31, 2020 Less: Less: Impact of Impact of Foreign of Recent Net Sales Growth (Decline) Reported Currency Operational Acquisitions/ Organic of Reportable Segments Basis Fluctuations Basis Divestitures Basis Endoscopy (6.0)% 0.3 % (6.3)% 0.0 % (6.3)% Urology and Pelvic Health (9.0)% 0.0 % (9.0)% (1.7)% (7.3)% MedSurg (7.3)% 0.2 % (7.5)% (0.7)% (6.7)% Cardiac Rhythm Management (12.1)% 0.2 % (12.4)% 0.0 % (12.4)% Electrophysiology (12.8)% 0.8 % (13.5)% 0.0 % (13.5)% Neuromodulation (12.8)% 0.1 % (13.0)% 2.8 % (15.7)% Rhythm and Neuro (12.4)% 0.3 % (12.7)% 0.8 % (13.4)% Interventional Cardiology (18.4)% (0.1)% (18.2)% 0.0 % (18.2)% Peripheral Interventions 13.3 % 0.2 % 13.1 % 15.6 % (2.5)% Cardiovascular (7.9)% 0.0 % (7.9)% 5.2 % (13.1)%
Year Ended December 31, 2020 Less: Impact of Net Sales Growth (Decline) Reported Currency Operational by Region Basis Fluctuations Basis 2 We have three reportable segments comprised of Medical Surgical (MedSurg), Rhythm and Neuro, and Cardiovascular, which represent an U.S. (9.7)% 0.0 % (9.7)% aggregation of our operating segments that generate revenues from the sale EMEA (Europe, Middle East and Africa) (7.4)% 1.0 % (8.4)% of medical devices (Medical Devices). We have included the results of BTG’s APAC (Asia-Pacific) (6.2)% 1.0 % (7.1)% Interventional Medicine business in our Peripheral Interventions operating segment since the date of acquisition. 3 As part of our acquisition of BTG, LACA (Latin America and Canada) (22.2)% (7.0)% (15.2)% we acquired a specialty pharmaceuticals business (Specialty Pharmaceuticals), 2 a stand-alone operating segment presented alongside our Medical Device Medical Devices (9.0)% 0.1 % (9.1)% reportable segments. On March 1, 2021, we completed the sale of the Specialty Specialty Pharmaceuticals3 n/a n/a n/a Pharmaceuticals business to Stark International Lux S.A.R.L. and SERB SAS, affiliates of SERB, for a purchase price of $800 million. 6 We define Net Sales (7.7)% 0.1 % (7.8)% Emerging Markets as including certain countries that we believe have strong growth potential based on their economic conditions, healthcare sectors, and our global capabilities in our Medical Devices business. Emerging Markets6 (12.7)% (3.5)% (9.2)% Currently, we include 20 countries in our definition of Emerging Markets.
Percentages are calculated using unrounded numbers and may not calculate precisely due to rounding. Amounts may not add due to rounding.
23006_031221_10k_8p Editorials.indd 6 3/15/21 10:22 AM Boston Scientific 2020 Annual Report Non-GAAP Reconciliations 7
Year Ended December 31, Operating Margin 2020 2019 2018 2017 2016 Operating margin, reported (0.8)% 14.1 % 15.3 % 14.2 % 5.3 % Less: Non-GAAP adjustments (20.1)% (12.0)% (10.2)% (10.8)% (18.8)% Operating margin, adjusted 19.3 % 26.1 % 25.5 % 25.0 % 24. 1 %
Year Ended December 31, Earnings Per Share 2020c 2019 2018 2017 2016 2015 GAAP earnings (loss) per share available to common stockholders $ (0.08) $ 3.33 $ 1.19 $0.08 $0.25 $(0.18) a Amortization expense 0.49 0.44 0.37 0.35 0.35 0.33 Goodwill and other intangible asset impairment charges 0.32 0.07 0.02 — 0.01 0.01a Acquisition/divestiture-related net charges (credits) 0.08 0.48 — 0.01 0.09 0.17 a Restructuring and restructuring-related net a charges (credits) 0.10 0.05 0.05 0.05 0.04 0.05 a Litigation-related net charges (credits) 0.18 0.05 0.06 0.12 0.37 0.52 Investment portfolio net losses (gains) (0.23) — — 0.03 — — EU MDR implementation costs 0.02 — — — — — Debt extinguishment net charges (credits) — 0.05 — — — 0.02a Deferred tax expenses (benefits) 0.03 (2.91) — — — — Discrete tax items 0.05 0.01 (0.23) 0.62 — (0.01)a Pension termination charges — — — — — 0.02a Adjusted earnings (loss) per share $ 0.96 $ 1.58 $ 1.47 $ 1.26 $1.11 $ 0.93 Less: Impact of 2018 net tax benefit b 0.07 Adjusted earnings (loss) per share, excluding 2018 net tax benefit $ 1.40 Adjusted EPS growth (decline) from prior year (39)% 8% 17% 13% 20% 11% Adjusted EPS growth from prior year, excluding 2018 net tax benefit n/a 13% 11% a Assumes dilution of 21.5 million shares for the year ended December 31, 2015. b Full year 2018 adjusted earnings per share was $1.47, which includes 5-Year Average Adjusted EPS growth 4% a $0.07 net tax benefit for the year. Excluding this net tax benefit of $0.07, our 2018 adjusted earnings per share grew 11 percent. 2019 adjusted EPS growth including the aforementioned 2018 net tax benefit is 8 percent and normalized for the 2018 net tax benefit is 13 percent. c As previously Year Ended December 31, announced, we issued mandatory convertible preferred stock (MCPS) in May of 2020. For 2020, the effect of assuming the conversion of MCPS into Adjusted Free Cash Flow (in millions) 2020 2019 shares of common stock was anti-dilutive, and therefore excluded from the calculation of EPS. Accordingly, GAAP Net loss and Adjusted net income were Operating cash flow, reported $ 1,508 $1,836 reduced by cumulative preferred stock dividends of $33 million, as presented Less: Purchases of property, plant and equipment 376 461 in our consolidated statements of operations, for purposes of calculating Add: Proceeds on disposals of property, plant and GAAP Net loss available to common stockholders. We have assumed dilution equipment 12 7 of 13.8 million common stock equivalents related to employee stock options for all or a portion of the non-GAAP adjustments, which were anti-dilutive for Free Cash Flow 1,144 1,382 GAAP purposes due to our Net loss position. Plus: Restructuring and restructuring-related payments 110 66 Plus: Acquisition-related payments 202 266 Plus: EU medical device regulation payments 29 4 Plus: Special Tax Payments (Refunds/Credits) 76 (42) Plus: Litigation-related Settlements 420 330 Adjusted Free Cash Flow $ 1,980 $2,007
Year over year change (1)%
Percentages are calculated using unrounded numbers and may not calculate precisely due to rounding. Amounts may not add due to rounding.
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