Backend-as-a-Service
The biggest real distinction between Appwrite and Medplum is straightforward: Appwrite uses hybrid pricing with $25/mo/project (Pro), a free tier, enterprise plan available; Medplum uses freemium with paid upgrades. Appwrite sits at hybrid pricing with $25/mo/project (Pro), a free tier, enterprise plan available and carries low lock-in, while Medplum sits at freemium with paid upgrades and carries low lock-in. Appwrite is a fit when you need mobile, teams — typical scenarios include mvp/prototyping speed. Medplum is aimed at healthcare startups building ehr or patient-facing apps on fhir with modern tooling, with workloads like open-source fhir-native ehr backend for digital health teams as the common case. The honest trade-off: Appwrite is explicitly not for complex custom business logic; Medplum is not intended for non-healthcare projects or teams that can't invest in learning fhir. On cost specifically, pricing model matters more than sticker price — one workload can make Appwrite cheaper while a different shape flips the answer to Medplum.
Quick take
Appwrite is for mobile, teams; Medplum is for healthcare startups building ehr or patient-facing; decide based on cost model and budget.
 Appwrite | | |
|---|---|---|
| Category | Backend-as-a-Service | Backend-as-a-Service |
| Pricing Model | hybrid | freemium |
| Entry Price | $25/mo/project (Pro) | — |
| Free Tier | Yes | Yes |
| Billing Complexity | low | — |
| Developer Experience | 5/5 | 4/5 |
| Pricing Transparency | 5/5 | 3/5 |
| Lock-in Level | low | low |
| Migration Complexity | low | — |
| Data Portability | Full — you own the data | — |
| Enterprise | Available | — |
| GitHub Stars | 55.7k | 2.3k |
| License | BSD-3-Clause | Apache-2.0 |
Low — open-source, self-hosted, standard under tofrom
Migration difficulty: low
Data you keep: Full — you own the data
API standard: REST API, open-source
Risk notes: Low — open-source, self-hosted, standard under tofrom
💡 Standard protocols make switching straightforward
Choose Appwrite if your primary workload is mobile, teams and hybrid pricing ($25/mo/project (Pro)) is acceptable.
Not for: Complex custom business logic
Choose Medplum if your primary workload is healthcare startups building ehr or patient-facing apps on fhir with modern tooling and low switching cost matters.
Not for: Non-healthcare projects or teams that can't invest in learning FHIR
Check each tool's dedicated page for deeper reviews, setup notes, and pros/cons.
Appwrite publishes an entry price of $25/mo/project (Pro); Medplum's entry price is not in our data, so a definitive comparison is not possible without a quote from Medplum.
Migrating from Appwrite to Medplum is generally feasible because Appwrite has low lock-in, so data and configuration are usually portable. Since both tools sit in the same category (Backend-as-a-Service), the conceptual mapping is closer, but you still need to validate feature parity against your specific workload. Plan migration as a project, not a script: inventory integrations, test on non-production workloads, and keep Appwrite running in parallel until Medplum is verified.
On our 0–5 developer experience scale, Appwrite scores higher (5/5 vs 4/5 for Medplum). The gap is one point — meaningful but not decisive, since DX is workflow-dependent. Still, score your own tasks: DX is subjective and tied to stack assumptions.
Medplum is in the same category as Appwrite (Backend-as-a-Service), so it's a reasonable alternative to evaluate. Medplum is aimed at healthcare startups building ehr or patient-facing apps on fhir with modern tooling, while Appwrite targets mobile, teams — that difference should drive the switch decision. Note that Medplum is explicitly not for non-healthcare projects or teams that can't invest in learning fhir — if that describes your workload, it's not a viable replacement.
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