The NFZ: The Payer Who Never SignsNarrow moat

Synektik (SNT) — moat facet

The NFZ never buys anything from Synektik, and it decides how much Synektik sells.

The most important party in Synektik's robotic business never appears on its customer list. The National Health Fund pays for the operations that justify a hospital's robot. It began with dedicated reimbursement for robotic radical prostatectomy from 1 April 20221, at twice the rate for laparoscopic or open surgery2, and added endometrial and colorectal cancer from 1 August 20233.

NFZ-reimbursed robotic operations (thousand)2,120225,42023nearly 112024Polityka Zdrowotna, NFZ data
Operations up five-fold in two years.

The money grew quickly: 59 million złoty for 2 100 operations in 2022, 167 million złoty for 5 400 in 20234, and about 300 million złoty for nearly 11 000 in 20245. That is roughly 27 thousand złoty to 31 thousand złoty per operation6, which is what the hospital has to cover the robot, the service and the instruments from.

The NFZ decides which operations are worth doing robotically in a public hospital. Robotic operations for other cancers, such as pancreas, liver or stomach, are not yet reimbursed7. Every addition to the list is a step change in demand for Synektik's instruments; the absence of additions is a ceiling.

The tariff is what made the decision easy. The robotic prostatectomy rate introduced in April 2022 was twice the laparoscopic or open one, and within three months 17 hospitals had registered to bill it, each committing to at least 100 procedures a year8.

Follow NFZ spending on robotic operations: it sets the budget from which Synektik's recurring revenue is paid.

Moat trajectory: Widening

Spending up five-fold in two years.

The number that tests this moat
Reported
NFZ spending on robotic cancer operations
about 300m zł in 2024 (167m zł in 2023)

The public budget behind Polish procedures.

Source: Polityka Zdrowotna on NFZ spending on robotic surgery ↗
References
  1. ReportedIt began with dedicated reimbursement for robotic radical prostatectomy from 1 April 2022, at twice the rate for laparoscopic or open surgery, and added endometrial and colorectal cancer from 1 August 2023.
    Synektik interim report for the fiscal year to 30 September 2022 - revenue, segments, installed base in Poland, Czechia and Slovakia, the first dedicated reimbursement and example tenders. — October 2021 - September 2022 · publ. November 2022 · source ↗
  2. ReportedIt began with dedicated reimbursement for robotic radical prostatectomy from 1 April 2022, at twice the rate for laparoscopic or open surgery, and added endometrial and colorectal cancer from 1 August 2023.
    Rynek Zdrowia - report on robotic surgery in Poland in the first half of 2022: five Versius robots against two new da Vinci sites, leasing and pay-per-procedure removing a minimum 10 million złoty outlay, the robotic prostatectomy tariff twice the laparoscopic one, 17 hospitals in three months. — First half of 2022 · publ. 2022 · source ↗
  3. ReportedIt began with dedicated reimbursement for robotic radical prostatectomy from 1 April 2022, at twice the rate for laparoscopic or open surgery, and added endometrial and colorectal cancer from 1 August 2023.
    Synektik quarterly report for the fourth quarter of the fiscal year to 30 September 2023 - revenue up 168%, order intake, recurring revenue, installed base and procedures. — October 2022 - September 2023 · publ. November 2023 · source ↗
  4. ReportedThe money grew quickly: 59 million złoty for 2 100 operations in 2022, 167 million złoty for 5 400 in 2023, and about 300 million złoty for nearly 11 000 in 2024.
    Polityka Zdrowotna - NFZ spending on robotic cancer operations: 2 100 operations for 59 million złoty in 2022, 5 400 for 167 million złoty in 2023, about 300 million złoty on nearly 11 000 in 2024; only prostate, colorectal and uterine cancer reimbursed; average cost about 30 thousand złoty. — 2022-2024 · publ. 2025 · source ↗
  5. ReportedThe money grew quickly: 59 million złoty for 2 100 operations in 2022, 167 million złoty for 5 400 in 2023, and about 300 million złoty for nearly 11 000 in 2024.
    Polityka Zdrowotna - NFZ spending on robotic cancer operations: 2 100 operations for 59 million złoty in 2022, 5 400 for 167 million złoty in 2023, about 300 million złoty on nearly 11 000 in 2024; only prostate, colorectal and uterine cancer reimbursed; average cost about 30 thousand złoty. — 2022-2024 · publ. 2025 · source ↗
  6. Moat Explorer calcThat is roughly 27 thousand złoty to 31 thousand złoty per operation, which is what the hospital has to cover the robot, the service and the instruments from.
    Moat Explorer calculation from Synektik's reported figures (thousands of złoty unless stated). Market value: 352,60 złoty x 8 529 129 shares = 3 007,4 million złoty (about 3,0 billion złoty); at the NBP rate of 3,8570 = $779,7 million (about $780 million). Trailing revenue to June 2026: 681 598,6 - 482 060,1 + 733 427,1 = 932 965,6 (about 933 million złoty). Trailing continuing net profit: 126 019,2 - 85 705,2 + 137 952,7 = 178 266,7; over 8 529 129 shares = 20,90 złoty; P/E 352,60 / 20,90 = 16,9. Equipment and IT segment EBITDA over segment revenue: 187 190,7 / 631 915,5 = 29,6% (FY2025); 143 577,5 / 579 299,1 = 24,8% (FY2024); 98 943,8 / 410 834,1 = 24,1% (FY2023); 29 865,3 / 139 272,7 = 21,4% (FY2022); 18 636,4 / 100 878,6 = 18,5% (FY2021); 19 605,9 / 112 126,1 = 17,5% (FY2019). Radiopharmaceutical segment EBITDA margin: 16 061,3 / 52 937,4 = 30,3% (FY2025); 16 276,6 / 46 615,7 = 34,9% (FY2024). Recurring revenue, trailing: 374,7 / 59,8 = 6,3 times (September 2022 to June 2026); installed base 142 / 37 = 3,8 times. Recurring revenue per year-end robot: 311,3 / 113 = 2,75 million złoty (FY2025); 193,9 / 86 = 2,25 million złoty (FY2024). Procedures per year-end robot, FY2025: Poland 19 800 / 75 = 264; Czechia and Slovakia 12 500 / 38 = 329. Revenue per average employee: 681,6 / 221 = 3,08 million złoty. Export share: 183,7 / 681,6 = 27,0%. Equipment segment share of revenue excluding intragroup sales: 631,1 / 681,6 = 92,6% (about 93%). Intuitive products: 44,9% x 681,6 = 306,0 million złoty; other equipment, IT and service 681,6 - 306,0 - 50,5 = 325,1 million złoty. Synektik market value over the Estonian contract: 3 007,4 / 41 = 73 (roughly seventy). Dividend paid February 2026: 10,75 x 8 529 129 = 91,7 million złoty; dividend per share 10,75 / 0,45 = 23,9 times since 2021. Free cash flow: FY2025 78,3 - 17,4 = 60,9 million złoty; FY2024 89,6 - 44,9 = 44,7 million złoty. IT4KAN price over market value: 4,15 / 3 007,4 = 0,14%. Recurring revenue, April-June 2025: 103,6 / 1,26 = 82,2 million złoty. Backlog plus active offers at June 2026: 44,2 + 160,8 = 205,0 million złoty. NFZ spending per robotic operation: 59 / 2,1 = 28 thousand złoty (2022); 167 / 5,4 = 31 thousand złoty (2023); 300 / 11 = 27 thousand złoty (2024). NFZ-funded PET studies: 96,1 / 89,3 - 1 = 7,6% (about 8%); per scanner 96 100 / 37 = about 2 600. Affidea: 29,0% x 52,9 = 15,3 million złoty, against segment EBITDA of 16,1 million złoty. Synektik's installed base as a share of Intuitive's: 142 / 11 710 = 1,2%. Czech and Slovak installed base: 42 / 16 = 2,6 times. Equipment segment purchases from others: 100 - 80,2 - 6,8 = 13,0%. Years of exclusivity from September 2026 to 31 December 2031: about 5,3. Year-end P/E and P/S (market value at 30 September over net profit and revenue; continuing profit from FY2024): 122,8 / 9,136 = 13,4 and 122,8 / 134,8 = 0,91 (FY2019); 190,2 / 8,811 = 21,6 and 1,52 (FY2020); 252,5 / 8,384 = 30,1 and 1,96 (FY2021); 237,5 / 10,709 = 22,2 and 1,42 (FY2022); 516,9 / 52,452 = 9,9 and 1,16 (FY2023); 1 635,9 / 98,909 = 16,5 and 2,62 (FY2024); 2 149,3 / 126,019 = 17,1 and 3,15 (FY2025); market values from closing prices of 14,40 złoty, 22,30, 29,60, 27,85, 60,60, 191,80 and 252,00 x 8 529 129. — October 2018 - June 2026 · publ. September 2026 · source ↗
    Method: Arithmetic on figures reported in Synektik's financial statements, management board reports, factsheet and market data; operands shown in the source line.
  7. ReportedRobotic operations for other cancers, such as pancreas, liver or stomach, are not yet reimbursed.
    Polityka Zdrowotna - NFZ spending on robotic cancer operations: 2 100 operations for 59 million złoty in 2022, 5 400 for 167 million złoty in 2023, about 300 million złoty on nearly 11 000 in 2024; only prostate, colorectal and uterine cancer reimbursed; average cost about 30 thousand złoty. — 2022-2024 · publ. 2025 · source ↗
  8. ReportedThe robotic prostatectomy rate introduced in April 2022 was twice the laparoscopic or open one, and within three months 17 hospitals had registered to bill it, each committing to at least 100 procedures a year.
    Rynek Zdrowia - report on robotic surgery in Poland in the first half of 2022: five Versius robots against two new da Vinci sites, leasing and pay-per-procedure removing a minimum 10 million złoty outlay, the robotic prostatectomy tariff twice the laparoscopic one, 17 hospitals in three months. — First half of 2022 · publ. 2022 · source ↗
Sources
Generated September 24, 2026