Beyond initial development, healthcare apps incur:
Server maintenance: $15K-$25K/year
Security updates: $20K-$40K annually
Feature enhancements: $30K-$60K per major release
Hidden costs include:
App store compliance (5-10% of project cost)
Patient onboarding systems ($8K-$15K)
API maintenance for lab/EHR integrations ($12K-$18K/year)
Plan for 5-year TCO (Total Cost of Ownership) being 2.5x initial development cost.