On 14 April, when we published our analysis, Elekta was trading at SEK 55.05. Before the year-end report, the stock closed at SEK 61.45, up 11.6%. After the report, the share price fell to SEK 53.35, roughly a 13% drop in a single session, bringing it to about 3% below our initial publication level.
The report highlights contrasts. Adjusted EBIT for Q4 was SEK 902M, with a margin of 18.9%, compared to 16.3% last year. The full-year adjusted EBIT margin increased to 11.2% from 8.6%, marking the highest level in five years and confirming the successful delivery of the Elekta Reset programme.
Cash flow after continuous investments totalled SEK 1,392M for the year, marking the highest in five years, while net debt decreased to SEK 3,191M from SEK 3,465M. Cost savings have now surpassed the initial target of SEK 500M, with management explicitly stating that results are ahead of schedule. The dividend remains at SEK 2.40 per share.
The market's negative reaction is reflected in the top line. Reported sales declined by 8% to SEK 4,762M in Q4 (-1% at constant currency), but the more significant indicator is the book-to-bill ratio of 0.96, marking the first quarter below 1.0x and confirming the warning signal we mentioned in our downside scenario.
Gross order intake decreased by 15% in constant currency. Management explains this decline is mainly due to project delays in the Middle East caused by regional conflict, along with a strategic shift to stricter order acceptance standards, including prepayment requirements and clearer site delivery schedules.
Historically, Elekta's order intake grew significantly faster than realized revenue, leading to last year's backlog impairment. CEO Just-Bomholt mentioned that the revised book-to-bill ratio now offers a more reliable indicator of future revenue. However, management chose not to specify how much of the Q4 order slowdown is due to a stricter filtering process versus actual market softness, with further details to be provided at the Capital Markets Day.
The SEK 1,096M non-cash impairment included SEK 851M for capitalized development costs and SEK 235M for goodwill, mainly related to Kaiku Health in Finland. It was combined with an additional SEK 284M provision based on a new expected credit loss model. Additionally, ESTRO 2026 generated over 120 abstracts from more than 30 institutions supporting the MR-Linac clinical case. While this strengthens the long-term product story, it does not impact the short-term commercial outlook.
A ROIC of 9.86% indicates that the operating business is generating cash returns that exceed its cost of capital. Meanwhile, the Damodaran-adjusted ROE of -0.50% confirms that value creation at the equity level has not yet been realised.
The FCF-to-Market Cap yield of 11.06% remains attractive. The FCF-to-Dividend coverage ratio of 2.8x indicates a well-protected payout, while the Net Debt / (EBITDA - CAPEX) ratio of 2.9x remains at a manageable level.
The share price at SEK 53.45 is in the lower half of the interquartile range, between our P25 of SEK 44.41 and the median of SEK 56.39, indicating it remains in the base case territory rather than the downside zone. Profitability and cash flow are exceeding expectations, but order intake has significantly weakened.
The quarter with a book-to-bill ratio below 1.0 triggers the explicit warning we identified in the downside scenario. The upcoming Capital Markets Day on June 17, where mid-term targets through 2028/29 will be shared, now represents the key turning point.
The full analysis is available https://newsletter.kobenresearch.com/p/elekta
DISCLAIMER
Author: David López, Koben Research. First published: May 29, 2026
This publication is intended for educational and informational purposes and does not constitute investment, financial or trading advice, nor an offer, solicitation or personalised recommendation to buy, sell or hold any financial instrument.
The author is not a licensed financial advisor, broker or dealer, and Koben Research is not authorised or regulated by the CNMV or any other financial supervisory authority. As of the date of publication, the author holds no position in the issuer covered, has no intention to take any position within the following 30 days, and has received no compensation from the issuer. Quantitative projections derive from a GARCH + Historical Flexible Probabilities + Monte Carlo framework with t-Student; they are model outputs, not price targets.
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