The verdict in three sentences
A SaaS health vendor launches fast but bills you 30 to 80 EUR per user per month, which becomes heavy once you pass 40 active accounts. A custom-built platform costs 70,000 to 160,000 EUR upfront but belongs to you and then runs on a flat maintenance fee. In both cases, certified health-data hosting is a non-negotiable legal requirement for a clinic.
SaaS vendor or custom: the real math
The instinct is to compare the sticker price. The right method compares the full three-year cost, including licences, certified hosting and operations. For a 50-user clinic, the vendor subscription often hides tiers and paid modules (billing, analytics, patient portal).
| Item (2026 ballpark) | Health SaaS vendor | Custom build |
|---|---|---|
| Setup / initial licence | 5,000 - 15,000 EUR | 70,000 - 160,000 EUR |
| Monthly subscription | 30 - 80 EUR / user | 0 (you own it) |
| Monthly cost at 50 users | 1,500 - 4,000 EUR | included in maintenance |
| Certified health hosting | often included | 800 - 2,500 EUR / month |
| Maintenance / evolutions | limited to vendor roadmap | 800 - 1,800 EUR / month |
| 36-month total (50 users) | 60,000 - 150,000 EUR | 110,000 - 230,000 EUR |
| Workflow customisation | low | total |
Custom becomes profitable once your headcount passes 40-50 users, or when your care pathways do not fit a generic vendor's boxes.
Compliance and key modules
Any personal health data hosted on behalf of a third party requires certified health-data hosting. That is the point that separates a clinic project from a plain management tool. Here are the bricks to budget.
| Module | What it delivers | Budget impact |
|---|---|---|
| Online booking | fewer calls, multi-practitioner agenda | 8,000 - 18,000 EUR |
| Electronic patient record | history, reports, documents | 15,000 - 35,000 EUR |
| Billing / insurance | quotes, invoices, insurers | 12,000 - 28,000 EUR |
| Certified health hosting | mandatory legal compliance | 800 - 2,500 EUR / month |
| Secure patient portal | results, messaging, reminders | 10,000 - 22,000 EUR |
| Full delivery timeline | design to production | 6 - 10 months |
Allow 6 to 10 months from scoping to production for a full booking + records + billing scope.
Mini case study
Take Dr Fontaine, director of a 55-staff private clinic in Manchester. With a vendor at 60 EUR per user per month across 50 accounts, he pays 3,000 EUR/month, or 108,000 EUR over 36 months, hosting included but without the patient portal, which is billed separately.
A custom build at 130,000 EUR plus 1,400 EUR maintenance and 1,500 EUR certified hosting comes to 130,000 + 36 x 2,900 = 234,400 EUR over 36 months. Pricier short term, but from year four the gap flips: the clinic pays only 2,900 EUR/month versus 3,000 EUR-plus on the vendor side, while owning a tool shaped to its pathways. If headcount rises to 80 users, the vendor climbs to 4,800 EUR/month while custom stays flat.
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FAQ
Is certified health-data hosting really mandatory?
Yes, as soon as identifiable health data is hosted on behalf of a third party. Budget 800 to 2,500 EUR/month depending on volume and redundancy in 2026.
How long to deliver a custom clinic platform?
Six to ten months for a booking, patient records and billing scope. An MVP focused on online booking can ship in 3-4 months.
At what headcount does custom pay off?
Generally beyond 40-50 active users, or when vendor licences durably exceed 2,500-3,000 EUR/month.
Can we migrate from an existing vendor?
Yes, via a data migration. Budget 8,000 to 20,000 EUR for mapping, cleansing and the switchover with no record loss.
What maintenance budget after go-live?
Between 800 and 1,800 EUR/month for fixes, security and regulatory evolutions, excluding certified hosting.
Let's scope your project. Tell us your number of practitioners, priority modules (booking, records, billing) and indicative budget, and we will frame the compliant scope. 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.
