- Q4 Revenue & EBITDA Performance $536M revenue (2% organic growth in Q4, 5% full-year), $98M EBITDA, and $1.91 EPS.
- 2026 Financial Guidance EBITDA of $400M–$430M, EPS of $7.75–$8.45, and 41% adjusted gross margin with 25% operating expenses to revenue.
- Tariffs & Divestiture Impact $40–50M unanticipated tariffs and $25M IV Solutions divestiture reduced 2026 EBITDA below $500M target.
- Free Cash Flow & Debt Strategy 2026 free cash flow improvement prioritized for debt paydown, aiming for 2x leverage ratio within half a turn.
- Product & Regulatory Progress FDA warning letter closed, 510(k) approvals for Medfusion 5000 and CADD pumps; Infusion Systems growth driven by LVP and competitive wins.
Guidance for 2026
The company expects consolidated organic revenue growth in the low to mid-single-digit range for 2026. Consumables growth is expected to be driven by volume increases and higher growth markets for oncology and other niche categories. Infusion Systems guidance reflects accelerated growth in the LVP line driven by competitive wins. Adjusted gross margin for 2026 is expected to be around 41%, and adjusted operating expenses as a percentage of revenue are expected to be approximately 25%.
Valuation Metrics
With a P/E Ratio of 550.67, the stock appears to be richly valued. However, the EV/EBITDA ratio of 14.52 suggests that the company's enterprise value is reasonable relative to its EBITDA. The Net Debt / EBITDA ratio of 3.01 indicates that the company still has some deleveraging to do, but it is making progress. The company's guidance for 2026 implies an EBITDA range of $400 million to $430 million, which is still short of the $500 million target due to unanticipated tariffs and the divestiture of IV Solutions.
Operational Highlights
The company's Infusion Systems business has a complete platform solution that will anchor the segment for the next 10-plus years. The consumables business is expected to create niche markets and expand capacities in the core business. The company is working to exit the remediation phase by the end of 2027 and expects to see benefits from manufacturing synergization and logistics consolidations. With a solid backlog and a new product cycle, the company feels well-positioned for 2026.
Outlook
Analysts estimate next year's revenue growth at 4.4%, which is in line with the company's guidance. With a strong finish to 2025 and a solid outlook for 2026, ICU Medical is well-positioned to deliver on its long-term targets. However, the company's high P/E Ratio suggests that the stock may be fully valued, and investors will need to monitor progress on deleveraging and margin expansion to justify the current valuation.