What Management Said
Read the full Q4 2025 transcript ↗Today, we will discuss Baxter's fourth quarter results, along with our financial outlook for the full year 2026. This morning, a press release was issued with our preliminary earnings results and updated outlook. On the call, we will reference operational growth, which excludes the impact of foreign exchange, MSA revenues from Vantive, and the previously announced exit of IV Solutions from China. We will also reference organic growth, which excludes the impact of foreign exchange, MSA revenues from Vantive, and any impact from future business acquisitions or divestitures.
Total company adjusted earnings from continuing operations were $0.44 per diluted share. While responses have varied, in general, customers are waiting for additional clarity on the nature and timing of the additional corrections that we will look to deploy. Margins were pressured by both an unfavorable mix of sales as well as some non-recurring items, including inventory adjustments. The Healthcare Systems and Technologies segment had another quarter of consistent performance, including a contribution from the recently launched Connex 360 monitor in the Front Line Care division.
As I said during our last earnings call and reiterated last month, I am focused on three main priorities. Most significantly, we are delayering levels of leadership, including removing the segment management layer and embedding critical functional roles directly in each of our businesses. We've also taken actions within our IV Solutions business to rightsize a support footprint to align to the lower demand environment, which we believe is a new baseline in the market. In Pharma, in addition to market demand softness, supply and backorder challenges have impacted revenue and driven unfavorable product mix.
What went well
- Fourth quarter global sales from continuing operations totaled $3 billion, up 8% on a reported basis and 3% operationally, with growth across all segments, and the top line exceeded management's expectations.
- Advanced Surgery capped a strong year with 11% growth, driven by solid demand for hemostats and sealants, strong commercial execution across regions, and steady procedure volumes.
- The Healthcare Systems and Technologies segment delivered another quarter of consistent performance, including a contribution from the newly launched Connex 360 monitor in Front Line Care, and total U.S. capital orders for CCS rose nearly 30% year over year with a strong order book and no observed slowdown in U.S. hospital capital spending.
- Drug Compounding grew 18% on continued strong demand for services outside the U.S., and management noted it is the fastest cash-cycle business in the portfolio.
- Free cash flow generation exceeded $450 million in the quarter, in line with expectations, supporting the balance sheet and deleveraging priority.
- Management advanced its turnaround priorities, internally announcing a new operating model that delayers leadership and gives each business full P&L accountability, and rolling out the Baxter Growth and Performance System (GPS).
What went wrong
- Adjusted EPS from continuing operations of $0.44 fell short of expectations, with results described as disappointing.
- Margins were pressured by unfavorable product and geographic mix, non-recurring items including roughly $40 million of inventory and other adjustments, higher manufacturing and supply costs, tariffs, and a higher tax rate.
- IV Solutions U.S. demand remained below historical levels as fluid-conservation clinical practice changes following Hurricane Helene continued to weigh on volumes, and the Novum IQ LVP shipment and installation hold continued to depress infusion pump sales.
- The Pharmaceuticals segment was weak, with Injectables and Anesthesia down 9% on a difficult prior-year comparison, soft pre-mix demand, IV-push substitution, and softer inhaled anesthesia demand, compounded by supply and backorder challenges and a supplier issue; Pharma operating margin was only 5.8%.
- Segment operating margins declined year over year: MPT down 110 bps to 15.4% and HST down 330 bps to 15.2%.
Guidance Changes
| Metric | Period | Current guidance |
|---|---|---|
| Outlook basis | FY2026 | shifting to organic growth measure going forward (Methodology change) |
| Free cash flow | FY2026 | expected to improve vs. 2025, back-half weighted (Improvement) |
| Stranded cost elimination | by end of 2027 | on track to eliminate stranded costs by end of 2027 (Reaffirmed) |
| Q1 2026 profile | Q1 2026 | most challenging quarter; earnings skewed to H2 (New) |
| R&D investment | FY2026 | at or above historical levels (Sustained/up) |
| Pricing contribution | FY2026 | reduced contribution from pricing (Lower) |
| Investor Day | FY2026 | held off / postponed (Withdrawn) |
Performance Breakdown
| Metric | YoY | Note |
|---|---|---|
| Total sales (continuing ops) | +8% reported, +3% operational | Growth across all segments; reported includes $84M Vantive MSA revenue and FX |
| Adjusted EPS (continuing ops) | $0.44, below expectations | Unfavorable mix, non-recurring/inventory adjustments, higher tax rate, partly offset by pricing |
| MPT sales | +4% | Growth in Infusion Therapies and Technologies plus continued Advanced Surgery strength |
| ITT sales | +1% | IV solutions benefited from favorable prior-year comparison, partly offset by lower Novum IQ LVP pump sales |
| Advanced Surgery sales | +11% | Solid hemostats/sealants demand, strong commercial execution, steady procedure volumes |
| HST sales | +4% | Double-digit Surgical Solutions growth and Patient Support Systems momentum; CCS +4%, Front Line Care +3% |
| Pharmaceuticals sales | +2% | Drug Compounding +18% offset by Injectables and Anesthesia -9% on tough comps, soft pre-mix, IV-push substitution, soft anesthesia |
| MPT operating margin | 15.4%, -110 bps | Higher manufacturing/supply costs, unfavorable mix, inventory adjustments, tariffs; partly offset by pricing and Kidney Care TSA income |
| HST operating margin | 15.2%, -330 bps | Unfavorable product and geographic mix, increased corporate allocation, tariffs; partly offset by TSA income |
| Pharmaceuticals operating margin | 5.8% | Higher manufacturing/supply costs, unfavorable mix, price erosion, inventory adjustments, increased corporate allocation post Kidney Care sale |
Earnings Call Themes & Trends
| Topic | Previous mention | Current period | Trend |
|---|---|---|---|
| Turnaround / stabilize-strengthen-improve priorities | introduced on prior call | actions in flight; new operating model, GPS rollout, early in journey | Advancing |
| Baxter GPS (Growth and Performance System) | rolled out in October | first President's Kaizen held; driving forecasting accuracy and accountability | Expanding |
| Operating model redesign | — | delayering, removing segment management, full P&L accountability per business; Pharma combined with ITT | New |
| Novum IQ LVP ship/installation hold | previously discussed; uncertain customer behavior | net impact more modest than guided; hold assumed in place for full year; corrections progressing | Ongoing/uncertain |
| Deleveraging / balance sheet | ongoing priority | FCF >$450M in Q4; deleveraging precedes M&A | Progressing |
| Vantive TSA / stranded costs | deal closed Jan 31, 2025 | TSAs tail off in 2026, mostly fall in early 2027; stranded costs to be eliminated by end 2027 | On track |
| Hurricane Helene fluid-conservation impact | discussed previously | clinical practice changes persist, treated as new baseline weighing on IV solutions volumes | Persisting |
| Tariffs | not present in H1 2025 | a margin headwind, expected to continue into 2026 | Worsening |
Q&A Summary
David Roman (Goldman Sachs): With strategic review, innovation catch-up, and deleveraging in motion, how are you ensuring business sustainability against competitors and gaining visibility for forecasting?
Hider: Customers view Baxter as essential (touching 350M+ patients/year), but performance must improve via stabilizing, strengthening the balance sheet, and continuous improvement, with accountability pushed to the lowest levels and innovation (Connex 360, Dynamo Stretcher) prioritized. Grade: Forecasting accuracy is being improved structurally through GPS, with cross-functional alignment and daily/weekly operating mechanisms to surface issues earlier.
David Roman (Goldman Sachs): What progress on reducing G&A/support costs reimbursed by Vantive via the TSA, and how does the TSA run off versus retained costs?
Grade: 2025 had roughly 40 bps remaining net impact including cost takeout and TSA income, and Baxter is on track; TSAs (typically 24 months from the Jan 31, 2025 close) start tailing off in 2026 and mostly fall off in early 2027, with stranded costs committed to be eliminated by end of 2027.
Robbie Marcus (JPMorgan): Can you bridge Q4 2025 gross/operating margins to the 2026 guide and give finer detail on Q1 cadence?
Grade: Q1 is expected to be the most challenging quarter due to seasonality, a tough ITT prior-year comparison (~150 bps / $40-50M one-time distributor build), continued Novum return uncertainty, non-repeating Drug Compounding strength, absorption headwinds from selling higher-cost capitalized inventory, pressured Injectables/Anesthesia margins, and incremental interest expense; no specific numerical guidance provided.
Vijay Kumar (Evercore ISI): Guidance assumes the Novum ship hold stays in place all year, so what have you told customers and will they wait a year?
Hider: Customers can continue using the device under existing instructions and mitigating actions while corrections progress; Baxter has a strong pump portfolio (Spectrum LVP, Novum syringe, Spectrum on IQX, PureView launching early Q2) to support customers through the transition.
Larry Biegelsen (Wells Fargo): Pharma operating margin is ~9% and lower in Q4, with Compounding likely low-margin; why keep Compounding and how do you improve Pharma margins?
Hider: Baxter likes Pharma's fundamentals and has combined it with ITT for synergies (common customers/call points); margin issues include a facility output problem (action team already improving it) and a supplier challenge being worked through over part of the year. Grade: Compounding's mix dilutes margins but it is the company's fastest cash-cycle business, a benefit.
Travis Steed (Bank of America): Are you assuming infusion pump share gains or losses in 2026, and was the ~$50M sequential jump in international CCS one-time?
Grade: Sees good opportunity with Spectrum as an innovating workhorse that now speaks with the Novum syringe; the international CCS increase was not viewed as one-time but reflects a strong order book, competitive wins, and broadly strong capital spend, with OUS performance improving after being a headwind last year.
Danielle Antalffy (UBS): How do you view the portfolio's state, where are the underappreciated opportunities, and where can the product portfolio ramp?
Hider: Baxter has market leadership across multiple categories, a resilient portfolio, and deep customer relationships; innovation is the key enabler with a 'base hit, not grand slam' cadence, GPS as the foundation, some smaller international exits planned in 2026, strength in Advanced Surgery, and capital allocation starting with deleveraging before any future M&A from a strong funnel.
More on Baxter International Inc
Reported 2026-02-12 · figures from the Baxter International Inc Q4 2025 earnings call.
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