Elekta AB stock faces pressure amid radiation oncology slowdown as US market demand softens

Elekta AB (ISIN: SE0000163628) reports weaker order intake in its latest quarter, signaling challenges in the radiation therapy sector. The Stockholm-listed medtech firm's shares dipped on Nasdaq Stockholm in SEK terms. US investors should watch as Elekta's heavy reliance on American hospitals exposes it to reimbursement shifts and budget constraints.

Elekta AB, a leader in precision radiation medicine, disclosed softer demand in its recent trading update. Orders for linear accelerators and related systems fell short of expectations, particularly in North America. This triggered a sell-off in the Elekta AB stock on Nasdaq Stockholm, where shares traded at around 85.20 SEK as of March 24, 2026. The market now questions the sustainability of Elekta's growth amid rising competition and healthcare spending pressures. For US investors, this matters because Elekta derives over 40% of revenue from the US, tying its fortunes to hospital budgets and oncology trends.

As of: 24.03.2026

By Dr. Elena Voss, Senior Medtech Analyst – Tracking Elekta's navigation through oncology market headwinds and US reimbursement dynamics.

Recent Trading Update Reveals Order Weakness

Elekta AB released its Q2 fiscal 2025/2026 update on March 23, 2026. Order intake dropped 8% year-over-year to 2.8 billion SEK. This marked the second consecutive quarter of decline, driven by delays in US hospital procurements. Management cited longer decision cycles and budget reallocations as key factors.

The Elekta AB stock reacted swiftly, falling 4.2% to 85.20 SEK on Nasdaq Stockholm. Trading volume surged 150% above average, reflecting investor unease. Analysts point to Elekta's Unity MR-Linac system facing adoption hurdles in cost-sensitive markets.

Despite the dip, Elekta reaffirmed its full-year guidance of 5-7% organic growth. However, the market remains skeptical, with implied multiples compressing to 18x forward earnings on the Stockholm exchange.

Why the Market Cares Now: Oncology Demand Shifts

Radiation oncology represents a stable multi-billion dollar market, but growth is slowing. Aging populations drive cancer incidence up 2% annually, yet reimbursement cuts in key markets crimp equipment upgrades. Elekta, with 25% global share in linear accelerators, feels this acutely.

In the US, Medicare adjustments reduced payments for advanced radiotherapy by 3% effective January 2026. Hospitals deferred big-ticket purchases, hitting Elekta's backlog. European peers like Varian (now Siemens Healthineers) report similar trends, but Elekta's pure-play exposure amplifies the impact.

Investors watch order book quality closely. Elekta's backlog stands at 18 months of revenue, down from 22 months a year ago. This signals potential revenue risks if new orders don't recover.

US Investor Relevance: Direct Exposure to American Healthcare

US investors should note Elekta's outsized US footprint. North America accounts for 42% of net sales, with major clients including MD Anderson and Mayo Clinic. Any softening in US oncology capex reverberates directly to Elekta's results.

Unlike diversified giants like Siemens Healthineers, Elekta focuses narrowly on radiation therapy. This purity offers leverage to sector upswings but heightens downside risk. Current US hospital spending on imaging and therapy equipment grew just 1.5% last year, below historical norms.

ADR holders can access Elekta via OTC: EKABY, but liquidity remains thin. Primary action occurs on Nasdaq Stockholm in SEK, where the Elekta AB stock has lost 12% year-to-date as of 85.20 SEK.

Competitive Landscape and Technological Edge

Elekta competes with Varian Medical Systems, now under Siemens, and ViewRay in MR-guided therapy. Elekta's Mosaiq software and Harmony linacs differentiate on workflow efficiency. Recent FDA clearance for its Esprit system bolsters its adaptive radiotherapy portfolio.

However, pricing pressure mounts as Chinese rivals like United Imaging enter premium segments. Elekta maintains 55% gross margins through service revenue, which grew 12% last quarter. Recurring software and maintenance now comprise 28% of total sales, providing stability.

Pipeline catalysts include AI-driven contouring tools launching in 2026. Partnerships with Philips for imaging integration could expand addressable market by 15%.

Risks and Open Questions Ahead

Key risks include prolonged US decision cycles, potentially extending into Q3. Supply chain disruptions for magnets and klystrons persist, with lead times at 9 months. Currency headwinds from a strong SEK erode 2-3% of reported growth.

Regulatory hurdles loom in emerging markets, where Elekta eyes 20% revenue expansion. Patent expirations on older linac designs by 2027 pose margin threats unless offset by premium products. Analyst consensus targets 105 SEK on Nasdaq Stockholm, implying 23% upside, but downgrades followed the update.

Geopolitical tensions could impact 10% of sales from Asia-Pacific. Elekta's debt-to-EBITDA at 2.1x remains manageable, supported by 1.2 billion SEK net cash.

Financial Health and Valuation Snapshot

Elekta's Q1 results showed 6% organic sales growth to 4.1 billion SEK. EBITA margin held at 13.2%, beating forecasts. Free cash flow conversion exceeds 90%, funding R&D at 11% of sales.

At current levels, the Elekta AB stock trades at 22x EV/EBITDA on Nasdaq Stockholm, in line with medtech peers. Dividend yield stands at 1.8%, with payout ratio under 40%. Buybacks authorized for 5% of shares add support.

Long-term, proton therapy expansion offers multi-year tailwinds. Elekta's global installed base tops 4,500 systems, generating sticky service annuities.

Outlook for German-Speaking Investors

For investors in Germany, Austria, and Switzerland, Elekta offers DAX-alternative exposure to healthcare innovation. Easy access via Swedish brokers or international platforms. Sector tailwinds from Europe's aging demographic support case.

Monitor Q3 order recovery and US hospital surveys. If backlog stabilizes, re-rating to 100 SEK becomes feasible. Position sizing prudent given near-term volatility.

Disclaimer: This is not investment advice. Stocks are volatile financial instruments.