Aging Populations And China Expansion Will Drive Device Adoption

Key Takeaways

• Clinical innovation and regulatory momentum are expected to accelerate global adoption of LivaNova's therapies, unlocking new markets and strengthening pricing power and margins.
  
• Strategic focus on recurring revenue, service monetization, and operational efficiency should improve earnings quality and support the shift to higher-margin, innovative products.
  
• Mounting cost pressures, regulatory risks, and shifting treatment preferences threaten demand, pricing power, and margins despite LivaNova's continued investment in innovation and market expansion.

Catalysts

A medical technology company, designs, develops, manufactures, markets, and sells products and therapies for neurological and cardiac conditions worldwide.

• LivaNova is expected to benefit from increased global demand for advanced medical devices as aging populations drive higher procedure volumes, especially for cardiopulmonary products and neuromodulation therapies; this should sustain strong revenue growth, as evidenced by double-digit procedure growth, market share gains, and robust international expansion (notably the early Essenz launch in China).
  
• Expanded access and rising healthcare expenditures in emerging markets, combined with regulatory approvals ahead of schedule (e.g., China) and favorable reimbursement changes (such as potential 48% higher CMS reimbursement for VNS therapy), are likely to accelerate adoption and unlock new revenue streams, supporting top-line growth and improving operating leverage.
  
• The company's clinical innovations-including strong, durable VNS study data in epilepsy and depression, launch of disruptive next-generation OSA neurostimulation (p-HGNS), and continued product upgrades (such as the Essenz platform's software upgradability)-position LivaNova to capture share from the long-term shift toward minimally invasive, personalized therapies, which can drive pricing power and higher net margins.
  
• Upgrades to recurring revenue streams through increased placements of high-value equipment, capacity expansion in consumables, and software/service monetization strategies (especially in cardiopulmonary) are expected to boost recurring revenues and stabilize gross margins as higher-margin services grow within the business mix.
  
• Continued investment in strategic R&D and operational efficiency, supported by disciplined capital allocation and margin expansion initiatives, should allow LivaNova to improve net earnings, increase free cash flow, and accelerate the transition to a portfolio with higher-margin, innovative products as secular and company trends in digital health, outcome-based care, and regulatory favorability persist.

LivaNova Future Earnings and Revenue Growth

Assumptions

• Analysts are assuming LivaNova's revenue will grow by 6.4% annually over the next 3 years.
• Analysts assume that profit margins will increase from -16.1% today to 10.7% in 3 years time.
• Analysts expect earnings to reach $168.9 million (and earnings per share of $3.01) by about September 2028, up from $-211.3 million today. However, there is a considerable amount of disagreement amongst the analysts with the most bullish expecting $186 million in earnings, and the most bearish expecting $134 million.
• In order for the above numbers to justify the analysts price target, the company would need to trade at a PE ratio of 26.9x on those 2028 earnings, up from -14.6x today. This future PE is lower than the current PE for the GB Medical Equipment industry at 28.6x.
• Analysts expect the number of shares outstanding to grow by 0.55% per year for the next 3 years.
• To value all of this in today's terms, we will use a discount rate of 8.31%, as per the Simply Wall St company report.

LivaNova Future Earnings Per Share Growth

Risks

• Ongoing global healthcare cost pressures and increased reimbursement scrutiny may limit long-term pricing power for LivaNova's products, particularly as public health systems prioritize lower-cost treatments, negatively impacting revenue growth and profit margins.
  
• LivaNova's long-term growth forecasts rely on continued procedure growth, market share gains, and premium pricing in the cardiopulmonary segment; rising competition and/or commoditization could erode share and reduce profitability.
  
• Sustained high R&D expenses to support innovation (e.g., new neuromodulation and OSA technologies) expose the company to potential margin compression if product approvals are delayed or clinical/reimbursement milestones are not met, thereby lowering net earnings.
  
• The company remains exposed to regulatory, product safety, and supply chain risks (such as capacity constraints with third-party suppliers and field safety notices), which could lead to procedure deferrals, inventory write-offs, or operating disruptions-impacting both top-line revenue and net margins.
  
• The accelerated adoption of value-based care models and patient/physician preference for less invasive or non-device-based therapies may reduce demand for legacy device-based treatments (like VNS for epilepsy/depression), putting long-term pressure on both revenue and earnings.

Valuation

• The analysts have a consensus price target of $65.0 for LivaNova based on their expectations of its future earnings growth, profit margins and other risk factors. However, there is a degree of disagreement amongst analysts, with the most bullish reporting a price target of $80.0, and the most bearish reporting a price target of just $56.0.
• In order for you to agree with the analyst's consensus, you'd need to believe that by 2028, revenues will be $1.6 billion, earnings will come to $168.9 million, and it would be trading on a PE ratio of 26.9x, assuming you use a discount rate of 8.3%.
• Given the current share price of $56.59, the analyst price target of $65.0 is 12.9% higher.
• We always encourage you to reach your own conclusions though. So sense check these analyst numbers against your own assumptions and expectations based on your understanding of the business and what you believe is probable.