The verdict in three sentences
A mid-sized private clinic in Lyon amortises custom software between 40,000 and 120,000 EUR ex. VAT once it passes 25 to 30 active users, because a SaaS licence at 60-150 EUR/user/month becomes more expensive over four years. The deciding factor is not the sticker price but HDS-certified hosting and GDPR compliance, both non-negotiable for health data. Expect a 4 to 8 month timeline for a controlled go-live, tests and data reversibility included.
SaaS licence or custom build: the real math
Health SaaS reassures with a low entry cost and included maintenance, but its cost scales linearly with the number of practitioners and secretaries. Custom demands a heavy upfront investment, then stabilises on annual maintenance of 15 to 20 % of the build.
| Criterion | SaaS licence | Custom build |
|---|---|---|
| Upfront cost | 0-5,000 EUR ex. VAT | 40,000-120,000 EUR ex. VAT |
| Monthly cost | 60-150 EUR/user | 800-1,800 EUR (maintenance) |
| Time to launch | 2-6 weeks | 4-8 months |
| Workflow customisation | Limited | Full |
| HDS hosting | Included (verify) | To be contracted |
| Data reversibility | Variable | Contractual |
| 5-year total (30 users) | 130,000-270,000 EUR | 100,000-180,000 EUR |
Cost lines of a 2026 clinic project
The budget never stops at application development. Certified hosting, historical data migration and staff training weigh heavily on year one.
| Line item | 2026 range (EUR ex. VAT) | Note |
|---|---|---|
| Scoping and specs | 4,000-9,000 | Business workshops |
| Core build (booking, patients, billing) | 25,000-70,000 | Priority modules |
| Annual HDS hosting | 3,600-24,000 | Depends on volume |
| Existing data migration | 3,000-12,000 | Variable quality |
| Training and change management | 2,500-8,000 | Practitioners + admin |
| Annual maintenance | 6,000-20,000 | 15-20 % of build |
Mini case study
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Marc, director of an ambulatory surgery clinic in Lyon, manages 34 users. On SaaS at 95 EUR/user/month he pays 38,760 EUR ex. VAT per year, i.e. 193,800 EUR over five years. A custom build at 85,000 EUR ex. VAT plus 14,000 EUR/year of maintenance and HDS comes to 151,000 EUR over five years, with billing workflows aligned to his agreement. Net saving nears 42,800 EUR, and he owns his tool and his data.
FAQ
Is HDS hosting mandatory for a clinic? Yes, as soon as you host personal health data the host must be HDS-certified. Budget 300 to 2,000 EUR/month depending on volume and redundancy.
How long to deploy custom software? Between 4 and 8 months for a mid-sized clinic, including scoping, priority module development, testing and data migration. A scope limited to booking and billing can drop to 4 months.
Does SaaS really cost more? Beyond 25-30 users and over a 4 to 5 year horizon, SaaS often exceeds custom. Below 10 users, SaaS stays more rational.
Can we migrate from SaaS to a proprietary tool? Yes, but require a reversibility clause in the SaaS contract from day one, with a full data export in an open format. Without it, migration costs 3,000 to 12,000 EUR.
Can billing integrate with my accounting software? Yes, via API or normalised export. Budget 4,000 to 10,000 EUR for a robust integration with payment tracking and reconciliation.
Let's scope your project. Tell us your user count, priority modules (booking, EPR, billing) and indicative budget for a tailored estimate. Detailed quote within 48 h. WhatsApp +221 77 596 93 33.
Mohamed Bah
Fondateur, Kolonell
Passionate about digital and entrepreneurship in Africa, Mohamed has been helping Sénégalese businesses with their digital transformation since 2020. Founder of Kolonell, he believes every SME deserves a professional and accessible online présence.
