The verdict in three sentences
A vertical healthcare licence (Doctolib Pro type) costs 45 to 90 EUR per clinician per month and launches in days, but it locks you into its data model and bills every extra module. A custom electronic patient record means 40,000 to 85,000 EUR of development plus 900 to 1,800 EUR/month of maintenance, with mandatory certified health hosting (+250 to 600 EUR/month). The maths tips toward custom from 8 to 12 clinicians onward, and whenever your workflows (billing, insurance, multi-site scheduling) fall outside the standard box.
Vertical licence or custom: the true 3-year cost
The licence trap is the per-seat cost that climbs with growth. The custom trap is underestimating maintenance. Here is a 2026 order of magnitude for a 15-clinician clinic.
| Item | Vertical licence | Custom build |
|---|---|---|
| Setup / development | 3,000 EUR (config) | 40,000-85,000 EUR |
| Monthly subscription | 15 x 60 = 900 EUR/mo | Maintenance 900-1,800 EUR/mo |
| Compliant hosting | included | 250-600 EUR/mo |
| Year 1 cost | ~13,800 EUR | ~62,000 EUR (median) |
| Year 3 cumulative | ~35,400 EUR | ~95,000 EUR |
| Code ownership | no | yes (resellable asset) |
| Workflow customisation | limited | total |
Over three years the licence is cheaper on raw cash flow, but it creates no asset and its cost scales linearly with headcount. Custom becomes an amortised investment once you pass 20 clinicians or open a second site.
What makes up a patient-record quote in 2026
| Module | Effort (person-days) | Indicative budget |
|---|---|---|
| Patient record + history | 15-25 d | 9,000-15,000 EUR |
| Multi-clinician scheduling | 10-18 d | 6,000-11,000 EUR |
| Billing + insurance claims | 18-30 d | 11,000-18,000 EUR |
| Patient portal / SMS reminders | 8-14 d | 5,000-8,500 EUR |
| Compliance + health data GDPR | 6-12 d | 4,000-7,000 EUR |
| UAT + staff training | 8-12 d | 5,000-7,500 EUR |
Overall timeline runs 12 to 18 weeks. Certified health hosting is not optional: any personal health data must sit with a certified provider, which adds to the budget but protects you legally.
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Mini case study
Catherine, director of a 15-clinician multi-specialty practice in central London, runs three part-time receptionists on data entry and insurance claims. Each costs roughly 1,900 EUR loaded per month. A custom build at 62,000 EUR (year 1) automates 30% of admin time, i.e. 0.9 FTE freed, about 1,710 EUR/month recovered, or 20,520 EUR/year. Add reduced billing rejections (estimated 4,000 EUR/year). The custom premium over the licence (~26,200 EUR in year 1) is paid back in 13 to 15 months, then yields a recurring net gain.
FAQ
Is certified health hosting really mandatory? Yes. As soon as you store personal health data for a third party, certified hosting is required. Budget 250 to 600 EUR/month depending on volume and redundancy.
Can we migrate from Doctolib or another licence? Yes, via export of patient and scheduling data. Plan 5,000 to 10,000 EUR for migration and a 2-4 week dual-entry phase.
How much is maintenance after delivery? Maintenance sits between 900 and 1,800 EUR/month, roughly 15 to 20% of development cost per year, including fixes, upgrades and monitoring.
From how many clinicians does custom pay off? As a 2026 order of magnitude, the tipping point is around 8 to 12 clinicians, or as soon as you open a second site multiplying licences.
Do we own the code? Yes, with a custom build you own the source code: it is an asset you can grow or resell, unlike a subscription.
Let's scope your project. Tell us your clinician count, priority modules (patient record, insurance billing, portal) and indicative budget, and we will frame hosting and timeline. 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.
