Good morning, everyone. We are glad to welcome you at the webcast of C-RAD's financial report for the third quarter of 2023. My name is Greta Cattani, Global Marketing Director, and I am thrilled to be your moderator for today's session. We have an exciting agenda ahead, filled with valuable insights and updates. I'm delighted to introduce our CEO, Cecilia de Leeuw; and our CFO, Christoffer Herou, who will guide us through the financial results. Cecilia will kick off today's webcast by providing an overview of the financial highlights from Q3, shedding light on our progress and achievements. Following that, Christoffer will delve into a comprehensive financial review, providing valuable insights and key figures. He will then hand over the microphone back to Cecilia to summarize. Before we start, I'd like to remind you that we will not be taking any questions during the presentation.
We encourage you to save your questions for the Q&A session that will follow the presentation. During the Q&A session, I will unmute your microphones, and you will have the opportunity to ask your questions directly to Cecilia and Christoffer. We will not be taking any questions from the chat. To participate, simply click on the Raise Your Hand button, and I would like to let you know that this session is being recorded, and a recording of the webcast will be available after the presentation. Without further ado, let's get started. Cecilia, over to you.
Thank you, Greta, and it's great to be here today to present our third quarter. Before I go into the Q3 highlights, I'd like to remind you of the world that we act in. Cancer is unfortunately one of the world's biggest health challenges, and unfortunately growing. There are three main ways to treat cancer, and approximately half of all patients are treated using radiation therapy, either as the main treatment or as a combination with the surgery and chemotherapy. This is our space with our surface-guided radiation therapy or SGRT technology. What keeps us on our toes is to treat more patients safely. C-RAD contributes to both society and patients in several ways. Patient safety is the foundation for our technology, and the radiation dose needs to be delivered to the tumor with high precision, not to damage healthy tissue.
We continuously monitor the position of the body before and during each treatment, and that can be up to 30 sessions per patient, without the need for tattoos or markers. Our customers are mainly hospitals and clinics. We are well-established in the market and have global presence with our market-leading products. With a seamless integration to our industrial partners, our products speed up the workflow during the setup and treatment of the patients, and that increases efficiency, and hence, more patients can be treated. SGRT is becoming standard of care, and I'd like to highlight a few things. Last year, independent guidelines recognized the clinical benefits of our technology. And secondly, while initially focusing on breast cancer, we see more and more clinics now also using SGRT for other cancer types, for example, brain, lung, head, and neck.
Lastly, the investment is minor relative to the value of the patient safety and treatment efficiency, roughly some 5% of the total investment to equip the treatment room. Let's move into the results and a few highlights from our third quarter. I am pleased to share that we have a quarter of both growth and stable profitability, and the quarter has been active across all markets. Right after the end of the quarter, the most important industry trade show for the Americas, as well as globally, ASTRO, took place. The number of visitors are back to pre-COVID levels, and our demo was in constant demand. Order intake more than doubled to 169 million SEK, and this is very strong, even compared to the soft quarter in Q3 last year.
We are going into Q4 with a backlog of SEK 751 million, another all-time high. The top line was strong, with revenues up 33% in comparable quarters, to an all-time high of SEK 111 million. With our focus on profitable growth, we are capturing the market demand with a close eye on the cost, and I'm pleased that we continue to deliver on our path towards profitable growth. The EBIT of 19 corresponds to an EBIT margin of 17% in the quarter, and looking at the first nine months, it corresponds to an EBIT improvement from SEK 16 million to SEK 33 million. With increasing cash flow from operations to SEK 17 million from a negative SEK 11 million last year, we are not where we want to be.
The improvement program involves, you know, short-term cash collection, as well as addressing our terms and conditions, going forward. The breast cancer solution, the breast solution, VitalHold, developed in a collaboration with Accuray, on their Radixact System, is now available in the U.S., E.U., as well as other markets. Finally, we reached another milestone for the quarter, launching our latest software release and further enhancing our interoperability and seamless integration with our industrial partners. The release comes with improved usability, accuracy, and introduction of new innovative features. We ended the quarter on a high note, so let's take a look at some key deals, in the quarter. We reached a significant milestone in the field of highly advanced cancer treatment, receiving the large order from proton supplier IBA for multiple SGRT proton systems.
The order is part of the Spanish Ortega public tender, and the value is SEK 32 million. We've got two important orders from Germany, and I am pleased to see the significant trust in C-RAD's technology, and this is yet another proof of SGRT becoming standard of care in advanced cancer treatments. So the SEK 16 million order from a German clinic in North Rhine-Westphalia for both multiple systems and a service agreement, and earlier in the third quarter, we got a SEK 10 million order from Katholisches Klinikum in Bochum for multiple systems and a service agreement. And after the end of the quarter, actually, yesterday, we received a SEK 8 million order from a new customer, a prestigious German clinic in North Rhine-Westphalia that has chosen C-RAD as their partner for SGRT.
It's multiple systems and service agreement to an order value of SEK 8 million. So let's take a closer look at our markets and the sales performance. I am pleased to announce that we have growth in all markets in the quarter. Order intake increased 108% to SEK 169 million, an increase of 87% in constant currencies. Looking at the year-to-date, order intake grew 40% to SEK 376 million, an increase of 30% in constant currencies. It's good to see that Americas is starting to recover from the weak second quarter, increasing to SEK 26 million, and year to date, there is a decline with 21 percent. EMEA had an exceptionally strong quarter overall, including the large Spanish proton order and the two German orders.
Year to date, EMEA is up 81%. Activity levels in APAC continues to be high, and we are gaining traction across multiple regions across India, and we have continued recovery in China. Year to date, APAC is up 39%, including the large Australian order from last quarter, SEK 23 million. It is worth noting that, in addition to the orders just presented, we have growth in all regions, but also in both products and services. Products, which is the lion's share of our business, grew 79%. Services more than tripled with an impressive 244%. This is in line with our strategy to grow services and part of our active work to increase the service contract attachment rate. For example, we have taken the first service contracts in China.
Let's take a look at the impact the order intake had on our backlog, and the order backlog represents orders that have been received but not yet delivered nor invoiced. Order backlog increased 52% to 751 million SEK, and out of the order backlog, more than half is, or 57%, relates to products and 43% to services. We have a good spread across all markets and all sizes contract. With that, let's move into revenue per market. We have an all-time high of SEK 100 million , or 33% growth. This is 16% in constant currencies, and year to date, revenue is up 41% and 28% in constant currencies. In Americas, revenues increased 22%, and I'm pleased that we are gaining some traction on the important U.S. West Coast.
For the first nine months, we had a 12% growth. EMEA is executing on the strong order backlog, with revenues growing 35%, and year to date, the growth is 41%. Revenues in APAC grew 40% in the quarter and 69% for the first nine months, and the deliveries are spread across the full APAC region.... With that, over to you, Christoffer, for a closer look at the financials.
Thank you, Cecilia. Good morning, everyone. It's great to be here today to share the financial information from our third quarter. In this quarter, we are proud to have reached another all-time high in order backlog, all-time high revenue for a single quarter, highest EBIT for a single quarter with 19. At the same time, we have also items and processes to improve, and I look forward to further contribute to that. As Cecilia mentioned, the revenue of SEK 111 million corresponds to an increase of 33%. With this, we are continuing to show strength in the conversion from order backlog to revenues also in this quarter. Year to date, we see a strong growth of 41%, amounting to a revenue of SEK 286 million. After three quarters, we have almost reached the full revenues from 2022.
The gross profit margin remains healthy, with 65% in the quarter and 64% year to date. As you can see, the operating expenses have increased compared to last year, but they are at the same level in Q3 as in previous quarters during 2023, and I will touch more on that later on. The EBIT for the quarter of SEK 19 million and the year-to-date figure of SEK 33 million shows that we also, during this quarter, have taken substantial steps on our way towards profitable growth. Both products and services contribute to our revenue growth in the quarter, with 31% and 44%, respectively. Growing services is an important part of our strategy, and services part of the total revenues has grown significantly over the last years. Year to date, services share of the total revenue is 19%.
At the same time, as we are delivering the strong revenue growth, we are able to keep up our healthy gross margin, as I mentioned, to 65% in the quarter and 64% year-to-date. This results in a gross profit of SEK 72 million in the current quarter and a gross profit development year-to-date with an increase of 40%, which corresponds well to the year-to-date revenue increase of 41%. For the third consecutive quarter, we are pleased to see an improvement in EBIT to almost SEK 19 million, which corresponds to an EBIT margin of 17%. This is to be compared to the EBIT level of 14.6 from last year. Year-to-date, we see a steady EBIT improvement of almost SEK 17 million.
The operating expenses of SEK 53 million in the current quarter are more or less flat compared to the previous quarters in 2023. The increase compared to the level from last year is mainly explained by the investments in our organization within sales, services, and R&D, which were carried out at the end of 2022. The growth in order intake and revenues show that these investments have paid off. With this organization, we are looking forward to drive the business, continue the conversion of our all-time high order backlog into revenues, gross profit, and EBIT. In the graph to the right, you can follow the dotted lines to see that the revenues are continuing to increase at a higher rate than the operating expenses. This is important also on our path forward, achieving profitable growth. The cash flow in our company fluctuates between the quarters.
We managed to turn the negative cash flow from previous quarters in 2023 to a positive cash flow of SEK 8 million in the quarter. The working capital was still slightly negative, as the accounts receivables continued to increase in nominal figures. As mentioned during this presentation, we are in a steady growth phase with increased revenues, so from that perspective, an increase in accounts receivables is to be expected. But as said, and also in the presentation, from the previous quarter, we are actively working to speed up the cash collection, which includes many different measures. Some of the measures will have positive effects short term, while other actions are expected to show improvements medium or long term. I would like to remind you of our solid financial position with almost SEK 90 million in cash and an equity to asset ratio of 69% at quarter end.
As you are aware of, C-RAD is in a legal dispute with a former employee regarding a patent. The patent is a minor part in one of our main products. As we informed in the Q2 reporting, the Patent and Market Court of Appeal, at the end of June, ruled to partly award the counterpart compensation. As it stands now, C-RAD should compensate the counterpart SEK 4.4 million for past time and 1% royalty from 2020 up to 2029 on the net sales using the patent. The counterpart is to partly compensate C-RAD as well. Normally, the Patent and Market Court of Appeal is the last instance, but in this case, in the verdict, the Patent and Market Court of Appeals granted permission to appeal the decision to the Supreme Court. During this quarter, both C-RAD and the counterpart have appealed to the Supreme Court.
With that, I would like to hand it over to you again, Cecilia.
Thank you, Christoffer. SGRT is rapidly becoming a given in the clinics and part of the treatment workflow. Ultimately, it's about safety for the patient and the precise targeting of the tumor, while minimizing radiation exposure to healthy tissues. I'm excited to see how the increased demand for our technology is translated into our numbers. We have the best ever, SEK 111 million revenue, and an order intake of SEK 169 million. We are going into Q4 with an all-time high order backlog, both for products and services. It includes the large Spanish proton order, but is well spread across the regions and sizes. The cash flow has improved, but there is more to do. We had a solid third quarter, and I'm pleased with our strong revenue and order intake growth in all markets.
Our focus on profitable growth is starting to show in our numbers. In the first nine months, we improved EBIT from SEK 16 million- SEK 33 million, which is our best so far. In conclusion, I'd like to touch on our focus going forward. We continue to invest in our leading technology. Our innovation is centered around patient safety and workflow efficiency. The untapped demand is captured step by step, and even if we see many markets rapidly approaching standard of care, we are only in the beginning. Lastly, services is a strategic asset and is a priority for us, and it's, it's a priority for us to grow services, and it's important for two main reasons: making sure that the customers get the best out of our technology, and also for recurring revenue.
To execute on what I just mentioned, we are strengthening the team, within marketing and sales. Marketing Director, Greta Cattani, and VP Sales, EMEA, Vincent, for EMEA, Vincent Tallier, both come with strong industry background, and together, we are building an empowered and even stronger organization. And with that, it's time for questions, and over to you, Greta.
Thanks, Cecilia. As Cecilia mentioned, it's time for questions. If you wish to ask a question, please press the Raise Your Hand button. I will then turn your microphone on, and you will be able to directly ask your question to Cecilia and/or Christoffer. We already have a couple of questions, so I will now start with Christian Lee. So, you have to unmute yourself, and then you can speak.
Yes, good morning. I hope you can hear me.
Yes, very well.
Okay, great. Yes, good morning, and thank you for taking my questions. I have a couple of ones. The order intake for services increased by 244%. Were there any specific reasons for this strong growth? And it would be helpful to know how much China contributed to the order intake.
Yeah, so first of all, thanks, Christian, for noting the growth in services triple. That is great. And the reason for that is really, you know, our really forward-leaning and active approach to increase the attachment rate. And more and more, we see customers taking on service contracts, but we have also, in addition to that, actually looked at the contracts that we have and, you know, working to sign contracts. And in China, as mentioned, it's the first, it's starting on small levels, but really important for us going forward.
Then to fill in, there, Cecilia, also, it is not that it is one or two major orders that is doing this this amount in the order intake for services this quarter, but it is many different, medium-sized, or what you call it, orders. So that we find that very solid as well.
Yes, for sure. Because the large order from Spain did not include any services, right?
No. Correct.
Yeah. Okay, great.
We have an opportunity there going forward, you know, for sure, in when we start the deliveries.
Okay, thank you. And could you please talk a little bit about the potential you see for the service business in China? Have you seen changes to the sentiment of adding services to the products, or have there been one-offs in the third quarter?
No, I think this is again, as I mentioned, you know, we're starting from small numbers, but as part of our strategy, it is important for us to have service contracts. It keeps us closer to the customers. We are able to ensure that they are happy with our product. So, you know, we will continuously work with our customers to make sure that they sign service contracts.
Okay, perfect. And my last question, could you please give some color on the Chinese market, where you have seen slowdowns in purchasing patterns? Do you believe this is related to the anti-corruption campaign, or are there any other factors?
So I think in general, as I mentioned in the presentation, we see China getting back towards pre-COVID levels, and it's a very important market for us as a whole. We are market leaders. However, you know, it does fluctuate. Of course, you know, somewhat of a slowdown with the anti-corruption, for sure. But you know, we have a healthy pipeline, you know, where we have lots of interest from the customers, but we do see that things are fluctuating.
Okay. Thank you. I will jump back to the queue. Thank you.
Yeah.
Now, a second question by Mr. Jakobsson. Please unmute yourself.
Yeah. Can you hear me?
Very well.
Yeah. Okay. You had some large orders lately from Germany. Can you elaborate on what drives the demand of these orders in Germany?
So, you know, first of all, EMEA is a very important region for us. It's we are very strong. We are very strong in Germany, and I think in general, the uptake for SGRT is increasing. More and more clinics see that this is an important part of their workflow in their treatment. And I think as in, you know, some other markets, when you see a clinic that is bringing in SGRT, that creates some, you know, ripple effect. And we are actively working with the clinics and the last one that we actually released yesterday is a retrofit.
So that is an installation on an existing clinic, which is also a very sort of low threshold investment in patient care.
Okay. In Europe, APAC, and Americas, respectively, do you believe you are taking market share, or is the growth mostly coming from general market expansion?
So it's, as I mentioned, the interest in SGRT is increasing, so the uptake across the world is actually increasing. However, we have a very strong position, both in EMEA and in APAC, and Australia, for example, market leaders. We are market leaders in China, as I mentioned. We're very, very strong in Germany, and also, you know, the Central Eastern market, Central Eastern European markets are growing as well. So yes, we have a strong position in those markets.
So probably growing more than the market in general then, at the moment?
So it varies across the market, but definitely we see good traction in the market.
Okay. One more before I jump back to the queue. Has the Accuray integration led to any meaningful order amount so far?
So, as I also mentioned, it's very exciting. I mean, this is a collaboration that has been ongoing, that in August, the FDA approval was out, so, which is then, and now also the CE approval, or the sort of the EU approval. And that is something that creates lots of interest, and there is a strong funnel for VitalHold. Nothing is yet announced.
Okay
On the VitalHold side.
Yeah.
Then I'll jump back to the queue for now. Thank you.
Thank you.
I see no other hands raised.
Ah, okay. If there's not any additional, I'll just go on here for a while.
Then you're first in line again, Mikael.
Yeah. Thank you.
Yeah.
In Q2, you reported a slowdown in decisions by your US customers impacting the construction of new treatment facilities. Have you seen any tendency of this effect in other regions as well, or was this unique to the US?
So, I mean, with the macroeconomic situation, it's. I mean, I'm pleased that we are performing so well in that situation. I mean, the slowdown can be, of course, expected across the world. However, you know, we have not really seen any indications of that outside of the U.S.
Okay, that's nice.
So far.
How should we view-- Yeah, yeah, so far. How should we view your delivery capacity? Are you at the maximum right now, if we look at the Q3?
Yeah, do you want to take it?
I would say that, typically, we have higher activity at the end of the year, you know, we have this seasonality pattern. Also within the quarters, we have a lot of activity at the end of the quarters. So I think that, looking at the whole year or a whole quarter, we still have capacity to deliver more.
Okay. You wrote in the report that some customer installations, you have used external resources. How should we think about this? Is this a cost-efficient and sustainable way, or do you need to increase service personnel, you think?
I would say that, yeah, I mean, we are a big company in some aspects, and then in other aspects, we are not a big company. So of course, expanding our own services network, we need to do that cautiously and have a good business case every time when we employ a new full-time employee in our books, so to speak. So in some geographies, it can be a good decision for us now to bring in external partners for installation, where that makes sense. But, you know, once a geographic region reaches a certain.
Right.
Density of installations, then, then we can go ahead with our own employees. So that's
It's part of the profitable growth approach.
Yeah, I would say.
Hmm, that's prudent. Where in the organization today do you see need for increased capacity in FTEs, if any?
So, I mean, as Christopher just said, you know, we review constantly the organization and look into where and if we need to grow. But, you know, we have to look at both the top line and the cost. So, one area, of course, is the services part. You know, when and if we make the decision to where it's more cost-efficient to have our own people, and also if we would, you know, decide to go into a new market. But this is something that we take step by step and are very cautiously reviewing that in the leadership team.
Okay. So, nothing at the moment, really. But prudent approach, that sounds good. Can you elaborate on your tax situation? Because in the cash flow statement, you pay much less than stated in the income statement. And furthermore, you write that you are looking over your transfer pricing policy. What does this mean going forward for the years to come, do you think?
This is your question.
Yeah, yeah, and I think so, too. No, so that, yeah, that's correct, that we are reviewing our transfer price policy at the moment. We have some different legal entities throughout the world. So that is being updated. And as we write in the quarterly report, that we foresee that the tax rate for this whole year should not be linear in Q4, I mean, if you take Q1, Q2, Q3 into consideration. So we are looking at a positive cash positive tax effect in our P&L for Q4.
Yes.
Okay. That was all for me. Congratulations on a stellar report.
Thank you.
Thanks so much. I see no other questions raised. Maybe we just wait a few seconds more if someone has some last-minute curiosity fulfilled. Well, I see no other question raised, so I will take this time to thank you, Cecilia, Christopher, and everyone attending. First of all, thank you to Cecilia for, and Christopher, for providing us with a comprehensive understanding of the C-RAD performance during the third quarter. I would also like to extend my thanks to all the participants who joined us today. We are honored to have you here, here tonight. For those who have missed any part of this webcast or would like to revisit any information shared, a recording will be available on the website shortly. Thank you once again for joining us. We appreciate your continued support and look forward to making a difference in cancer care together.