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⚠ A Home Market Turning SoftModerate threat

Abbott Laboratories (ABT) — threat to the moat

Abbott's US Structural Heart sales fell 2.2% on a comparable basis in the first half of 2026 while international sales rose 12.4%.

The worry in Structural Heart is geographic. In the first half of 2026 US Structural Heart sales fell 9.6% on a reported basis while international sales rose 18.1%1. Comparable figures narrow the gap, with the US down 2.2% and international up 12.4%2, but the direction is the same.

Abbott Structural Heart comparable sales growth, first half 2026 (%)-2.2United States+12.4InternationalAbbott Q2 2026 earnings release, Medical Devices sales table
Down at home, up abroad.

The United States is where valve-repair devices are priced highest and where procedures are most established. Weakness there is harder to explain away than weakness in a newer market.

Abbott does not say what caused it in the release. Some of it is the transfer of Amulet to Electrophysiology, and some may be the end of the compensation payments a competitor made to the business, which Abbott excludes from comparable growth3. Neither explains a comparable decline.

The second quarter alone was worse than the half. US Structural Heart sales were $225 million, down 9.8% reported and 0.9% comparable4, against international sales of $372 million, up 12.1%5.

The United States is not a small part of this line. US Structural Heart sales were $449 million of $1,175 million in the first half of 20266, 38.2%7. A decline in that share of the business is enough to slow the whole line even while the rest grows by double digits.

The page's falsifier is simple. If US Structural Heart comparable growth returns above 5% by the end of 2026, the first half was noise; if it is still below zero, Abbott is losing procedures in its most profitable market for these devices.

References
  1. ReportedIn the first half of 2026 US Structural Heart sales fell 9.6% on a reported basis while international sales rose 18.1%.
    Abbott Laboratories second-quarter 2026 earnings release, Form 8-K exhibit 99.1 - sales by segment and business, comparable growth, income statement, specified items, guidance and the 410th consecutive quarterly dividend - Medical Devices sales by business, continuous glucose monitors, Amulet and TECTONIC. — Q2 2026 · publ. 16 July 2026 · source ↗
  2. ReportedComparable figures narrow the gap, with the US down 2.2% and international up 12.4%, but the direction is the same.
    Abbott Laboratories second-quarter 2026 earnings release, Form 8-K exhibit 99.1 - sales by segment and business, comparable growth, income statement, specified items, guidance and the 410th consecutive quarterly dividend - total sales, income statement, specified items, tax rate, guidance and the dividend. — Q2 2026 · publ. 16 July 2026 · source ↗
  3. ReportedSome of it is the transfer of Amulet to Electrophysiology, and some may be the end of the compensation payments a competitor made to the business, which Abbott excludes from comparable growth.
    Abbott Laboratories second-quarter 2026 earnings release, Form 8-K exhibit 99.1 - sales by segment and business, comparable growth, income statement, specified items, guidance and the 410th consecutive quarterly dividend - Medical Devices sales by business, continuous glucose monitors, Amulet and TECTONIC. — Q2 2026 · publ. 16 July 2026 · source ↗
  4. ReportedUS Structural Heart sales were $225 million, down 9.8% reported and 0.9% comparable, against international sales of $372 million, up 12.1%.
    Abbott Laboratories second-quarter 2026 earnings release, Form 8-K exhibit 99.1 - sales by segment and business, comparable growth, income statement, specified items, guidance and the 410th consecutive quarterly dividend - Medical Devices sales by business, continuous glucose monitors, Amulet and TECTONIC. — Q2 2026 · publ. 16 July 2026 · source ↗
  5. ReportedUS Structural Heart sales were $225 million, down 9.8% reported and 0.9% comparable, against international sales of $372 million, up 12.1%.
    Abbott Laboratories second-quarter 2026 earnings release, Form 8-K exhibit 99.1 - sales by segment and business, comparable growth, income statement, specified items, guidance and the 410th consecutive quarterly dividend - Medical Devices sales by business, continuous glucose monitors, Amulet and TECTONIC. — Q2 2026 · publ. 16 July 2026 · source ↗
  6. ReportedUS Structural Heart sales were $449 million of $1,175 million in the first half of 2026, 38.2%.
    Abbott Laboratories second-quarter 2026 earnings release, Form 8-K exhibit 99.1 - sales by segment and business, comparable growth, income statement, specified items, guidance and the 410th consecutive quarterly dividend - Medical Devices sales by business, continuous glucose monitors, Amulet and TECTONIC. — Q2 2026 · publ. 16 July 2026 · source ↗
  7. Moat Explorer calcUS Structural Heart sales were $449 million of $1,175 million in the first half of 2026, 38.2%.
    Moat Explorer calculation from Abbott Laboratories reported figures ($ millions unless stated; calendar years). Medical Devices: share of total reportable segment operating earnings 3,011 / 6,916 = 43.5% (2017), 4,533 / 13,422 = 33.8% (2021), 7,212 / 11,800 = 61.1% (2025); first half 2026 3,862 / 6,122 = 63.1%. Share of segment sales 21,387 / 44,311 = 48.3% (2025); first half 2026 11,392 / 23,750 = 48.0%. Segment margin 3,011 / 10,325 = 29.2% (2017), 3,038 / 11,787 = 25.8% (2020), 4,533 / 14,485 = 31.3% (2021), 7,212 / 21,387 = 33.7% (2025); Q2 2026 1,969 / 5,853 = 33.6%, Q2 2025 1,796 / 5,369 = 33.5%. Sales growth 2017-2025 (21,387 / 10,325)^(1/8) - 1 = 9.5% a year; operating earnings 2025 7,212 / 6,153 - 1 = +17.2%; sales 2025 21,387 / 18,986 - 1 = +12.6%. Diabetes Care 7,998 / 1,414 = 5.66 times (2017 to 2025); share of Medical Devices 1,414 / 10,325 = 13.7% (2017), 2,524 / 12,239 = 20.6% (2019), 4,328 / 14,485 = 29.9% (2021), 5,761 / 16,887 = 34.1% (2023), 7,998 / 21,387 = 37.4% (2025); share of company 7,998 / 44,328 = 18.0%; CGM share of Diabetes Care 7.6bn / 7.998bn = 95%. CGM growth 2019-2025 (7.6 / 1.842)^(1/6) - 1 = 26.6% a year. Abbott CGM sales over DexCom revenue 7,600 / 4,662.0 = 1.63 times. DexCom distributor share 3,959.0 / 4,662.0 = 84.9%. Product lines 2017 to 2025: Electrophysiology 2,764 / 1,353 = 2.04 times; Structural Heart 2,523 / 1,083 = 2.33 times; Heart Failure 1,448 / 643 = 2.25 times; Rhythm Management 2,649 / 2,132 - 1 = +24.2%; Neuromodulation 1,010 / 808 - 1 = +25.0%; Vascular 2,995 / 2,892 - 1 = +3.6%. Rhythm Management, Heart Failure, Vascular and Neuromodulation together 2,649 + 1,448 + 2,995 + 1,010 = 8,102 (2025) against 2,390 + 1,279 + 2,837 + 962 = 7,468 (2024), +8.5%. Diagnostics: margin 1,912 / 7,713 = 24.8% (2019), 6,237 / 15,526 = 40.2% (2021), 6,640 / 16,469 = 40.3% (2022), 2,433 / 9,988 = 24.4% (2023), 1,740 / 8,937 = 19.5% (2025); Q2 2026 499 / 3,092 = 16.1%, Q2 2025 372 / 2,173 = 17.1%. Share of segment operating earnings 6,640 / 12,831 = 51.7% (2022), 1,740 / 11,800 = 14.7% (2025). Sales 2025 8,937 / 9,341 - 1 = -4.3%. COVID testing share of Diagnostics sales 2022 8.4bn / 16.469bn = 51%, about half. Core Laboratory 5,360 / 4,063 - 1 = +31.9%. Rapid Diagnostics 2,454 / 10,061 - 1 = -75.6% (2022 to 2025). Point of Care 606 / 550 - 1 = +10.2%. Molecular 2020 peak 1,438 / 463 = 3.11 times 2017. Cancer Diagnostics share of Diagnostics Q2 2026 919 / 3,092 = 29.7%. Exact Sciences US share of 2025 sales 3,145 / 3,247 = 96.9%; purchase price over 2025 sales 20.6bn / 3.247bn = 6.3 times. China net sales 1,907 / 2,253 - 1 = -15.4% (2023 to 2025); China share of company 2,253 / 40,109 = 5.6% (2023), 1,907 / 44,328 = 4.3% (2025). Nutrition: margin 1,741 / 6,975 = 25.0% (2015), 1,705 / 7,409 = 23.0% (2019), 1,763 / 8,294 = 21.3% (2021), 706 / 7,459 = 9.5% (2022), 1,333 / 8,154 = 16.3% (2023), 1,558 / 8,451 = 18.4% (2025); Q2 2026 368 / 2,144 = 17.2%, Q2 2025 418 / 2,212 = 18.9%. Q2 operating earnings 368 / 418 - 1 = -12.0%. Sales 2021 to 2025 8,451 / 8,294 - 1 = +1.9%. Share of company sales 6,925 / 27,390 = 25.3% (2017), 7,409 / 31,904 = 23.2% (2019), 8,294 / 43,075 = 19.3% (2021), 8,154 / 40,109 = 20.3% (2023), 8,451 / 44,328 = 19.1% (2025). US Pediatric 2022 1,562 / 2,192 - 1 = -28.7%. International Adult 3,029 / 1,782 - 1 = +70.0% (2017 to 2025); share of Nutrition 3,029 / 8,451 = 35.8%. International Pediatric 1,816 / 2,112 - 1 = -14.0%. Sturgis: recalled brands 479 / 1,200 - 1 = -60%; Nutrition operating earnings 706 / 1,763 - 1 = -60%. Established Pharmaceuticals: margin 658 / 3,720 = 17.7% (2015), 848 / 4,287 = 19.8% (2017), 904 / 4,486 = 20.2% (2019), 889 / 4,718 = 18.8% (2021), 1,206 / 5,066 = 23.8% (2023), 1,290 / 5,536 = 23.3% (2025); Q2 2026 382 / 1,499 = 25.5%. Sales 5,536 / 3,720 - 1 = +48.8% (2015 to 2025); (5,536 / 4,287)^(1/8) - 1 = 3.2% a year (2017 to 2025). Key Emerging Markets share 4,167 / 5,536 = 75.3%. Segment sales growth 2025: Medical Devices +12.6%, Established Pharmaceuticals 5,536 / 5,194 - 1 = +6.6%, Nutrition 8,451 / 8,413 - 1 = +0.5%, Diagnostics -4.3%; net sales 44,328 / 41,950 - 1 = +5.7%. US share of 2025 net sales 17,126 / 44,328 = 38.6%; international share Q2 2026 7,377 / 12,593 = 58.6%. Further: Structural Heart compensation payments 89 / 2,523 = 3.5% of 2025 line sales. Diabetes Care added 7,998 - 6,805 = 1,193 in 2025. One point of CGM growth on 7.6bn = about 76. Medical Devices share of segment assets 10,689 / (3,540 + 4,791 + 8,273 + 10,689 = 27,293) = 39.2%. Total debt over total assets 32,608 / 109,215 = 29.9% (30 June 2026), 12,929 / 86,713 = 14.9% (end 2025). Net debt over Abbott shareholders' investment 27,005 / 51,110 = 0.53. Market value 173.21 / 217.86 - 1 = -20.5% (end 2025 to 5 October 2026). Second pass: US Structural Heart first half 2026 449 / 1,175 = 38.2%. Rapid Diagnostics 2,454 / 4,376 = 56% of 2020. Diagnostics Q2 2026 operating earnings 499 / 372 - 1 = +34.1%. Nutrition sales (8,451 / 6,925)^(1/8) - 1 = 2.5% a year (2017 to 2025); 8,451 / 7,409 - 1 = +14.1% (2019 to 2025). US Adult Nutrition 1,448 / 1,254 - 1 = +15.5% (2017 to 2025). Adult nutrition 3,029 + 1,448 = 4,477; pediatric 2,158 + 1,816 = 3,974 (2025). Total segment operating earnings 11,800 / 13,422 - 1 = -12.1% (2021 to 2025); Medical Devices 7,212 / 4,533 - 1 = +59.1%. First half 2026 dividends over operating cash flow 2,200 / 3,803 = 57.9%. DexCom revenue 2023 3,095.6 + 526.7 = 3,622.3; 4,662.0 / 3,622.3 - 1 = +28.7%; Abbott CGM 7.6 / 5.3 - 1 = +43.4% (2023 to 2025). US share of first half 2026 sales 9,490 / 23,757 = 39.9%. Diagnostics RPO 6,200 / 8,937 = 69% of 2025 Diagnostics sales; 6,200 / 5,360 = 1.16 times Core Laboratory sales. Libre 7.6 / 1.128 = 6.7 times (2018 to 2025). Medical Devices and Established Pharmaceuticals RPO 455 + 243 = 698, / 6,898 = 10.1%. Cash, debt and dividends: free cash flow 9,566 - 2,171 = 7,395 (2025), 8,558 - 2,207 = 6,351 (2024), 7,261 - 2,202 = 5,059 (2023); after dividends 7,395 - 4,116 = 3,279, about $3.3 billion. Dividends paid over free cash flow 4,116 / 7,395 = 55.7%; over net earnings 4,116 / 6,524 = 63.1%; 2025 dividend per share over adjusted EPS 2.40 / 5.15 = 46.6%; annual dividend 4 x 0.63 = 2.52 over trailing EPS 3.09 = 81.6%. Dividend per share 2.40 / 0.98 = 2.45 times, (2.45)^(1/10) - 1 = 9.4% a year (2015 to 2025). Total debt 3,033 + 9,896 = 12,929 (end 2025), 3,005 + 29,603 = 32,608 (30 June 2026); net debt 12,929 - 8,522 - 417 = 3,990 (end 2025), 32,608 - 5,104 - 499 = 27,005 (30 June 2026), 14,679 - 7,279 = 7,400 (end 2023), 14,125 - 7,967 = 6,158 (end 2024); 27,005 / 3,990 = 6.8 times. Remaining performance obligations 6,200 + 455 + 243 = 6,898, about $6.9 billion; Diagnostics share 6,200 / 6,898 = 90%; beyond 36 months 100% - 52% - 18% = 30%; over trailing twelve-month sales 6,898 / 46,585 = 14.8%, about 15%. Trailing twelve months to June 2026: net sales 44,328 - 21,500 + 23,757 = 46,585; net earnings 6,524 - 3,104 + 2,005 = 5,425; diluted EPS 3.72 - 1.77 + 1.14 = 3.09. Expected amortization 1.5bn (2030) / 2.6bn (2026) - 1 = -42%. Analyst target 120.26 / 100.10 - 1 = +20.1%. 2026 adjusted EPS guidance midpoints (5.55 + 5.80) / 2 = 5.675 (January), (5.38 + 5.58) / 2 = 5.48 (April), (5.45 + 5.60) / 2 = 5.525 (July). Year-end market value (stockanalysis) over net earnings and net sales: 2015 66.99bn / 4,423 = 15.15, / 20,405 = 3.283; 2016 56.55 / 1,400 = 40.39, / 20,853 = 2.712; 2017 99.34 / 477 = 208.26, / 27,390 = 3.627; 2018 127.04 / 2,368 = 53.65, / 30,578 = 4.155; 2019 153.61 / 3,687 = 41.66, / 31,904 = 4.815; 2020 194.06 / 4,495 = 43.17, / 34,608 = 5.607; 2021 248.87 / 7,071 = 35.20, / 43,075 = 5.778; 2022 191.43 / 6,933 = 27.61, / 43,653 = 4.385; 2023 191.09 / 5,723 = 33.39, / 40,109 = 4.764; 2024 196.18 / 13,402 = 14.64, / 41,950 = 4.677; 2025 217.86 / 6,524 = 33.39, / 44,328 = 4.915; 5 October 2026 173.21bn / 5,425 = 31.93, / 46,585 = 3.718 - Medical Devices, Diabetes Care and the device lines. — FY2015-Q2 2026 · publ. October 2026 · source ↗
    Method: Arithmetic on figures reported in Abbott Laboratories Forms 10-K and 10-Q and earnings releases, the DexCom Form 10-K, and stockanalysis.com market values; each operand is stated in the source line.
Sources
Generated October 6, 2026