Bioventus NASDAQ: BVS reported first-quarter 2026 results that management said put the company “off to a strong start” as it increased investment in several growth drivers while still expanding profitability and cash generation. On the call, the company also raised guidance for adjusted earnings per share and cash from operations, while reaffirming its full-year revenue outlook.
Management outlines three 2026 priorities
President and CEO Rob Claypoole said Bioventus entered 2026 focused on three priorities: accelerating long-term revenue growth through increased investment, increasing earnings while investing, and strengthening cash flow to improve capital allocation flexibility.
Claypoole said first-quarter revenue growth of 7% was “slightly ahead of our expectations,” supported by what he described as disciplined resource allocation, increased awareness of Bioventus’ “differentiated clinical and economic value,” and commercial execution across geographies and channels.
He emphasized that the company is directing investment toward four growth drivers—PNS, PRP, Ultrasonics, and international—supported by expansions of commercial teams, increased marketing, and additional physician training. Claypoole highlighted PNS as the largest investment area, saying it will represent “more than half of our planned investments this year.”
As part of that effort, Claypoole announced the hiring of Megan Rosengarten as general manager for PNS, citing her experience launching and scaling medical device businesses. “Bringing Megan on board at this early stage reflects our belief in the significant potential of our PNS business and our intention to scale the business aggressively,” he said.
First-quarter financial results
Senior Vice President and CFO Mark Singleton said first-quarter revenue totaled $132 million, up 7% year over year, “driven by solid performance across all three of our businesses.” Adjusted EBITDA was $24 million, up nearly $5 million, representing 24% growth. Adjusted EBITDA margin was 18%, an expansion of 260 basis points compared with the prior-year period.
Singleton noted foreign exchange provided a benefit in the quarter, with the company “benefited by almost $2 million” compared with the first quarter of last year due to FX movements.
Adjusted earnings were $0.15 per diluted share, compared with $0.08 a year earlier. Singleton attributed bottom-line improvement to revenue growth, higher adjusted gross margin, and lower interest expense, while also noting that investment increased operating expenses.
- Adjusted gross margin: 76%, up 110 basis points year over year, driven by a favorable rebate adjustment and a refund of prior-year tariffs.
- Adjusted operating income: $20 million, up nearly $3 million.
- Adjusted net income: $13 million, up $7 million.
Business segment performance and operational commentary
Singleton reported revenue growth in each of the company’s three businesses. Global Pain Treatments revenue increased 8% year over year, which he said was slightly above expectations due to “a favorable rebate adjustment in HA.” He added that from an operational standpoint, the company saw “a slight increase in volume growth” versus the prior year, though growth was impacted by a reduction in distributor inventory levels “as expected.”
During Q&A, Claypoole described the rebate benefit as tied to “a one-time process change by one of our commercial payer partners,” adding, “We don’t anticipate that a similar level of variability moving forward.” He said results otherwise were consistent with planning assumptions and reiterated expectations that revenue growth will accelerate in the second half of the year.
Singleton also addressed headwinds in the HA business, pointing to “one less selling day and the lower distributor inventory,” which he said were “both worth a couple of points of growth” in the quarter. Excluding those headwinds, he said operational growth would have been “in the mid-single digits.”
Global Surgical Solutions revenue grew 6% year over year, which Singleton said reflected “solid growth across the portfolio.” Claypoole told analysts the company’s plan calls for slower growth in the first quarter and then sequential improvement through the year, with expectations to reach double-digit growth in the second half as Bioventus gains share in BGS and sees benefits from investments in Ultrasonics, surgeon training, sales force expansion, and broader awareness efforts.
For Ultrasonics specifically, Claypoole said the company remains “very positive” and views it as a major growth driver in a “big $1 billion market.” He said the business has both capital and disposable components, with “the majority of the revenue coming from the disposable side,” and he expects Ultrasonics growth to accelerate through the year, with a goal of double-digit growth for the full year.
Global Restorative Therapies revenue increased 5% year over year. Singleton said the EXOGEN team delivered “another strong quarter,” and he reiterated expectations for mid-single-digit revenue growth for EXOGEN for the full year.
International revenue rose 17% year over year, or 11% on a constant-currency basis. Singleton said growth improved across Ultrasonics in Europe as the company increased awareness of its technology, and he pointed to “increased strategic focus, talent additions, and improved commercial execution” as factors supporting momentum.
Cash flow, leverage, and capital allocation
Cash flow from operations totaled $9 million, representing “more than a $28 million increase” versus the first quarter of last year, driven by higher profitability, lower interest expense, and favorable working capital, Singleton said. The company ended the quarter with $36 million in cash and $272 million in outstanding debt.
Singleton said debt declined $22 million during the quarter as Bioventus prioritized paying down its term loan. He added that the company expects its net leverage ratio to fall below 2 by the end of the second quarter of 2026, “ahead of schedule,” which management believes can generate additional interest expense savings and increase flexibility for future capital deployment.
Claypoole said Bioventus currently plans to continue using free cash flow to reduce debt as it strengthens the balance sheet.
Guidance updates and investment pacing
Singleton said Bioventus raised full-year 2026 guidance for adjusted EPS and cash from operations, while reaffirming revenue guidance. The updated outlook includes:
- Adjusted EPS: $0.75 to $0.79, up from prior guidance of $0.73 to $0.77
- Cash from operations: $84 million to $89 million, up $2 million from prior guidance
- Revenue: reaffirmed at $600 million to $610 million (provided March 5)
Singleton said the company expects year-over-year growth in revenue, adjusted EBITDA, and adjusted EPS to accelerate from the first half of 2026 to the second half as investments contribute to revenue. He added that guidance “does not assume additional impact from U.S. dollar fluctuation for the year.”
Asked about the pace of investment, Singleton said the company’s previously discussed $13 million investment plan is expected to ramp over the coming quarters. With the year 25% complete, he said Bioventus had invested “slightly less than that” so far and expects expenses to step up beginning in the second quarter and into the remainder of the year. He described investment focus areas as sales resources, clinical support, and medical education, with “a big portion” in PNS, along with Ultrasonics and PRP.
Claypoole also said PNS and PRP have moved “out of the pilot stage” and are now ramping. He added that the company is leveraging its existing HA commercial team for PRP, while building out a dedicated PNS team over the coming quarters. Claypoole reiterated the company’s expectation that PRP and PNS combined will contribute 200 basis points of growth in 2026.
In closing remarks, Claypoole said the company remains confident in its ability to “deliver above-market revenue growth, improve earnings, and accelerate our cash flow,” while continuing to invest in its growth drivers.
About Bioventus NASDAQ: BVS
Bioventus, headquartered in Durham, North Carolina, is a global medical device company specializing in orthobiologic solutions aimed at accelerating healing and improving patient outcomes in musculoskeletal conditions. The company develops and commercializes a portfolio of non‐surgical therapies designed to address bone healing, osteoarthritis pain management and soft tissue repair. Its flagship EXOGEN® Ultrasound Bone Healing System utilizes low‐intensity pulsed ultrasound technology to stimulate bone growth and has been widely used in the management of delayed fractures and nonunions.
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