Third Quarter 2026
Filed Nov 5, 2026ICU Medical Announces Third Quarter 2026 Results and Reaffirms Fiscal Year 2026 Guidance, Expecting Results at the High End of Range
Third-quarter GAAP revenue, gross profit, gross margin, net income, adjusted diluted earnings per share and adjusted EBITDA all improved from the prior-year period. The company reaffirmed its fiscal-year outlook and expects results toward the higher end of its guidance range, while nine-month GAAP revenue remained below the prior-year period because of the May 1, 2025 IV Solutions disposal.
Key metrics
shortened, hover for the filing’s print| Metric | Value | q/q | y/y |
|---|---|---|---|
| Total revenues, three months ended September 30, 2026 (in thousands)GAAP | $560.4M | – | 4 % |
| Gross profit, three months ended September 30, 2026 (in thousands)GAAP | $234.8M | – | – |
| Gross margin, three months ended September 30, 2026GAAP | 42% | – | – |
| Total operating expenses, three months ended September 30, 2026 (in thousands)GAAP | $182.4M | – | – |
| Income from operations, three months ended September 30, 2026 (in thousands)GAAP | $52.32M | – | – |
| Net income, three months ended September 30, 2026GAAP | $26.8M | – | – |
| Diluted earnings per share, three months ended September 30, 2026GAAP | $1.07 per diluted share | – | – |
| Adjusted diluted earnings per share, three months ended September 30, 2026non-GAAP | $2.44 | – | – |
| Adjusted EBITDA, three months ended September 30, 2026non-GAAP | $113.9M | – | – |
| Free cash flow, three months ended September 30, 2026 (in thousands)non-GAAP | $83.42M | – | – |
| Net cash provided by operating activities, three months ended September 30, 2026 (in thousands)GAAP | $99.59M | – | – |
| Total revenues, nine months ended September 30, 2026 (in thousands)GAAP | $1.64B | – | (3) % |
| Gross profit, nine months ended September 30, 2026 (in thousands)GAAP | $676.0M | – | – |
| Total operating expenses, nine months ended September 30, 2026 (in thousands)GAAP | $571.0M | – | – |
| Income from operations, nine months ended September 30, 2026 (in thousands)GAAP | $105.0M | – | – |
| Net income, nine months ended September 30, 2026 (in thousands)GAAP | $76.07M | – | – |
| Diluted earnings per share, nine months ended September 30, 2026GAAP | $ 3.02 | – | – |
| Net cash provided by operating activities, nine months ended September 30, 2026 (in thousands)GAAP | $218.6M | – | – |
| Free cash flow, nine months ended September 30, 2026 (in thousands)non-GAAP | $172.7M | – | – |
| Net Debt as of September 30, 2026 (in thousands)non-GAAP | $858.0M | – | – |
| TTM Adjusted EBITDA as of September 30, 2026 (in thousands)non-GAAP | $420.8M | – | – |
| Net Leverage Ratio as of September 30, 2026non-GAAP | 2.04 x | – | – |
Segments
| Segment | Revenue | q/q | y/y |
|---|---|---|---|
| Consumables, three months ended September 30, 2026Non-GAAP organic revenue growth was 5 %. | $298.4M | – | 5 % |
| Infusion Systems, three months ended September 30, 2026Non-GAAP organic revenue growth was 11 %; the Chief Executive Officer said third-quarter results were ahead of expectations for Infusion Systems. | $192.5M | – | 11 % |
| Vital Care, three months ended September 30, 2026Non-GAAP organic revenue growth was (10) %. Vital Care includes $4.2 million of contract manufacturing revenue, compared with $3.6 million in the prior-year period. | $69.5M | – | (11) % |
Amounts quoted below without a unit are in thousands, as in the filing’s tables. Per-share figures are as printed.
Fiscal Year 2026 outlook
- NoteGAAP net income: $73 million to $83 million
- NoteGAAP diluted earnings per share: $2.89 to $3.29
- NoteAdjusted EBITDA: $415 million to $435 million
- NoteAdjusted earnings per share: $8.60 to $9.00
- NoteThe Company expects to end the fiscal year towards the higher end of the guidance range.
What drove it
- Third-quarter total GAAP revenue growth was 4 %, and total non-GAAP organic revenue growth was 5 %.
- Third-quarter GAAP gross margin was 42%, compared with 37% in the same period in the prior year.
- Infusion Systems revenue was $ 192.5 million, with GAAP revenue growth of 11 % and non-GAAP organic revenue growth of 11 %.
- The company reported $ 10,358 of tariff refunds in its third-quarter adjusted EBITDA reconciliation.
- The company disposed of its IV Solutions business on May 1, 2025. The nine months ended September 30, 2025 included $127.4 million of revenue, including contract manufacturing revenue, primarily related to the disposed business.
Concerns
- Vital Care revenue was $ 69.5 million in the third quarter of 2026, compared with $ 78.0 million in the prior-year period, and GAAP revenue growth was (11) %.
- Nine-month total GAAP revenue was $ 1,642,347 (in thousands), compared with $ 1,690,558 (in thousands), with GAAP revenue growth of (3) %.
- Long-term debt was $ 1,133,096 (in thousands) as of September 30, 2026.
- The GAAP results included $ 6,610 of quality system and product-related remediation and $ 2,832 of impairment of equity method investment in the third-quarter non-GAAP reconciliation.
What to watch
- Whether fiscal-year GAAP net income of $73 million to $83 million, GAAP diluted earnings per share of $2.89 to $3.29, Adjusted EBITDA of $415 million to $435 million, and adjusted earnings per share of $8.60 to $9.00 finish toward the higher end of the respective ranges.
- Infusion Systems growth relative to the third-quarter 2026 GAAP and non-GAAP organic revenue growth of 11 %.
- Vital Care performance following third-quarter GAAP revenue growth of (11) % and non-GAAP organic revenue growth of (10) %.
- Cash generation and debt reduction following $ 218,645 of nine-month net cash provided by operating activities and $ 134,688 of principal repayments of long-term debt.
Balance sheet and cash flow
- Cash and cash equivalents as of September 30, 2026: $ 301,780 (in thousands); December 31, 2025: $ 307,963 (in thousands).
- Current portion of long-term debt as of September 30, 2026: $ 18,750 (in thousands); long-term debt: $ 1,133,096 (in thousands).
- Principal repayments of long-term debt for the nine months ended September 30, 2026: $ 134,688 (in thousands); prior-year period: $ 272,750 (in thousands).
- Purchases of property, plant and equipment for the nine months ended September 30, 2026: $ 45,999 (in thousands); prior-year period: $ 63,397 (in thousands).
- Net cash provided by operating activities for the nine months ended September 30, 2026: $ 218,645 (in thousands); prior-year period: $ 119,248 (in thousands).
Analysis
ICU Medical reported a stronger third quarter, with GAAP revenue of $560.4 million versus $537.0 million in the same period in the prior year. Gross profit increased to $234.8 million from $200.9 million, and GAAP gross margin rose to 42% from 37%. Income from operations was $ 52,322, compared with $ 13,719, while GAAP net income was $26.8 million, compared with a GAAP net loss of $(3.4) million.
The revenue mix was led by Consumables at $ 298.4 million and Infusion Systems at $ 192.5 million. Consumables recorded 5 % GAAP revenue growth, while Infusion Systems recorded 11 % GAAP revenue growth and was identified by the Chief Executive Officer as ahead of expectations. Vital Care revenue was $ 69.5 million and declined (11) % on a GAAP basis. The filing notes that the May 1, 2025 disposal of the IV Solutions business affected year-to-date comparisons, with the nine months ended September 30, 2025 including $127.4 million of related revenue.
Non-GAAP profitability also advanced. Adjusted diluted earnings per share was $2.44, compared with $2.03, and adjusted EBITDA was $113.9 million, compared with $105.9 million. The third-quarter reconciliation includes $ 10,358 of tariff refunds, while it also identifies quality system and product-related remediation, restructuring, stock compensation, amortization and other items as adjustments. Investors should distinguish the 42% reported GAAP gross margin from the adjusted gross-profit presentation, which excludes contract-manufacturing effects and other specified items.
Cash generation improved in the nine-month period, with net cash provided by operating activities of $ 218,645 and free cash flow of $ 172,685, compared with $ 119,248 and $ 55,893, respectively. ICU Medical reported $ 301,780 of cash and cash equivalents and $ 1,133,096 of long-term debt at September 30, 2026. It repaid $ 134,688 of long-term debt during the nine months and reported a non-GAAP net leverage ratio of 2.04 x.
Management reaffirmed fiscal-year 2026 guidance and stated that it expects to finish toward the higher end of its ranges. The outlook calls for GAAP net income of $73 million to $83 million, GAAP diluted earnings per share of $2.89 to $3.29, adjusted EBITDA of $415 million to $435 million, and adjusted earnings per share of $8.60 to $9.00. The key operating variables into year end are whether Infusion Systems sustains its growth, whether Vital Care stabilizes, and the extent to which the company realizes its stated higher-end guidance expectation.
Management, verbatim
Third quarter results were ahead of our expectations for Infusion Systems and generally in line with expectations for the remainder of the business.
Vivek Jain, Chief Executive Officer
Not in the filing
stated, not guessed- Previous-release outlook was not provided, so comparison of actual results with prior guidance is unavailable.
- Fiscal-year 2026 revenue guidance was not provided.
- Fiscal-year 2026 gross-margin guidance was not provided.
- Fiscal-year 2026 operating-expense guidance was not provided.
- Fiscal-year 2026 tax-rate guidance was not provided.
- Third-quarter capital-return amounts for share repurchases and dividends were not provided.
- Third-quarter adjusted EBITDA margin was not provided.
- Third-quarter free-cash-flow margin was not provided.
- Prior-quarter comparative figures for the reported metrics were not provided.
Written by an AI language model from the company’s SEC earnings filing (Form 8-K Item 2.02, or Form 6-K for a foreign private issuer). Every figure was checked against the filing text, and a metric whose value, prior period and change do not add up is dropped from the metrics. The model can still misread a table, in the metrics or in the text, so check a number in the filing before you rely on it. Consensus estimates, price targets and share-price reactions are not shown because they are not in the filing. AI-generated research, not investment advice.