ICU Medical, Inc.

Q2 revenue was $548 million, equal to 6% organic growth and 1% reported growth. Adjusted gross margin was 41%, adjusted EBITDA was $110 million, and adjusted EPS was $2.37 versus $2.10 a year ago. Management said adjusted EBITDA grew 10% year over year and adjusted EPS rose 13%, while free cash flow was $62 million and debt paydown totaled $50 million in the quarter. For 2026, the company raised adjusted EBITDA guidance to $415 million-$435 million from $400 million-$430 million, raised adjusted EPS guidance to $8.60-$9.00 from $7.75-$8.45, and now expects full-year adjusted gross margin of around 41.5%. Management also reiterated full-year adjusted operating expenses of about 25% of revenue, net interest expense of about $65 million, an adjusted tax rate of 25%, and diluted shares of 25.2 million.

Vivek Jain framed the quarter as evidence that ICU Medical is delivering on its plan to build a comprehensive infusion therapy company through differentiated products, innovation, and operational execution. He emphasized that the core businesses are growing consistently, that new product cycles are still early, and that the company is close to its vision of a common software framework across infusion platforms, with the Medfusion 5000 resubmission progressing this year. His tone was confident and measured, with repeated emphasis on discipline, long-term value creation, and avoiding value-destructive portfolio moves.

Brian Bonnell said adjusted gross margin of 41% was in line with expectations and explained that higher logistics costs from diesel were offset by lower tariff expense, including $8 million of tariff expense in the quarter and $20 million of tariff refunds. Adjusted SG&A was $112 million, or 20.4% of adjusted revenue, down 1 point year over year and sequentially, helped by IT integration efficiencies and expense timing. He noted $21 million of restructuring, integration and strategic transaction expense, $110 million of adjusted EBITDA, $62 million of free cash flow, $1.24 billion of debt, $298 million of cash, and net leverage of 2.3x after paying down $50 million of debt. He also said the company now expects better full-year gross margin, aided by lower tariffs and faster synergy capture, and that restructuring/remediation cash spend should come down in the second half.

Analysts pressed on the strength in Infusion Systems, asking whether it reflected an upgrade cycle or competitive wins. Management said the quarter was driven mainly by competitive wins and some earlier-than-expected installations, while the broader replacement cycle has not really started yet. Questions also focused on Medfusion 5000 timing, with management saying the amended FDA package should go back in this year, but they would not give a narrower date. On cash flow, tariff refunds, oil costs, SG&A efficiency, and Vital Care, management said there may be some additional tariff refunds but likely not at the $20 million scale, oil and diesel assumptions are now embedded in guidance, SG&A benefits are real but Q2 should not be treated as the run rate, and Vital Care remains a search-for-the-right-strategic-fit situation rather than an urgent sale.