HealthTechCost Optimizationeu-west-160 Days$7,701 → $4,658 / mo
Case Study · UK HealthTech

How a UK HealthTech cut their AWS bill by 40% in 60 days

A 4× growth-stage HealthTech serving European customers had AWS spending climbing faster than revenue. We delivered 40% reduction without touching reliability, and turned cost optimization into a sustained engineering practice.

This is an ongoing engagement. Work began with a secure AWS landing zone, followed by the cost optimisation described here.

Client Profile
UK HealthTech Scale-up
IndustryHealthTech / Digital Health
StageGrowth Stage
Team Size~140 employees
AWS Regioneu-west-1 (Ireland)
Engagement10 weeks total
ComplianceGDPR · ISO 27001
40%
Monthly bill reduction
$36.5k
Annualized savings
0
Reliability regressions
The Challenge

Engineering optimized for speed. Now finance needed the same.

After 4× growth in 18 months, AWS spend had become the second-largest line item in the company's P&L, and was still climbing. The CTO needed savings without slowing delivery.

Before, The Pain

$7,701 / month and growing

  • AWS bill grew 4× in 18 months, outpacing revenue growth
  • Reserved Instances purchased 18 months ago, never re-evaluated
  • EKS clusters provisioned for peak load, idle 60% of the day
  • 5 unattached EBS volumes from terminated instances
  • 3 RDS instances over-provisioned 4× actual workload
  • 40+ EC2 instances candidates for Graviton, still on x86
  • NAT Gateway egress costs rising due to VPC architecture
  • Engineers had no visibility into per-team cost
Goal, The Brief

30%+ reduction in 90 days

  • Cut monthly AWS bill by at least 30% within one quarter
  • Zero reliability regressions, production SLA must hold
  • No reduction in backups, multi-AZ, or DR capacity
  • Establish per-team cost visibility for engineering
  • Maintain ISO 27001:2022 evidence collection throughout
  • Build sustainable practice, not one-time savings
  • Read-only access only during audit phase
  • Daily standups, weekly written status to CTO + CFO
Our Approach

Three phases. Each one shipped savings.

Rather than a 12-week analysis with a giant remediation list at the end, we sequenced the work so savings appeared on the bill within the first two weeks, and compounded from there.

Phase 1 · Week 1 to 2 · Audit

Read-only audit + quick-win identification

Started with read-only AWS access via cross-account IAM role. Pulled 90 days of Cost Explorer data, ran Compute Optimizer recommendations, audited every Reserved Instance against actual usage, and inventoried idle resources.

  • Cost Explorer + Compute Optimizer deep review
  • Reserved Instance / Savings Plan portfolio analysis
  • Idle resource hunt across EBS, EIP, NAT, RDS, ALB, EKS
  • Per-service spend analysis and tagging audit
  • Outcome: 23-item savings roadmap, prioritized by $/month impact and risk
Phase 2 · Week 3 to 6 · Quick Wins

Quick wins locked in within 30 days

Started with the lowest-risk, highest-impact items first. Idle resource cleanup, RI/Savings Plan rebalancing, and right-sizing the worst-offender EC2 instances. Each change went through dev → staging → 5% canary → full production.

  • Removed 5 unattached EBS volumes
  • Right-sized top 22 over-provisioned EC2 instances
  • Re-balanced RI portfolio: sold mismatched RIs, bought Compute Savings Plans
  • Migrated CloudWatch Logs retention from indefinite to 90-day with archive
  • S3 Intelligent-Tiering migration on 3 largest buckets
Phase 3 · Week 7 to 10 · Deep Optimization + FinOps Culture

Further savings + sustainable practice

Architectural changes that took longer to validate but compounded existing savings. EKS rightsizing, Graviton migration for eligible workloads, NAT Gateway consolidation. In parallel, set up the per-team cost visibility and weekly review cadence that turns one-time savings into sustained discipline.

  • EKS cluster rightsizing with Karpenter for auto-scaling
  • Migrated 18 EC2 instances to Graviton
  • NAT Gateway consolidation, VPC endpoint usage
  • Aurora rightsizing on 3 RDS instances
  • Per-team cost allocation tags + Grafana dashboards
  • Cost Anomaly Detection set up with Slack alerts
  • Monthly cost review cadence: agenda, dashboards, owners
Architecture Changes

What changed under the hood, and what didn't.

The architecture diagrams below show the meaningful changes. Note what stayed the same: multi-AZ deployment, KMS encryption, multi-region backups, ISO 27001 evidence collection. We never traded reliability for cost.

Before

Pre-engagement state

  • EC222 instances oversized vs Compute Optimizer
  • RDS3 instances at 4× capacity
  • EKSStatic cluster sized for peak
  • RIsMismatched portfolio, 18mo stale
  • NAT GW3 deployed, 1 sufficient
  • EBS5 orphan volumes
After

Post-engagement state

  • EC222 right-sized · 18 on Graviton
  • RDS3 Aurora instances right-sized
  • EKSKarpenter auto-scaling enabled
  • SP/RI70/20/10 portfolio rebalanced
  • NAT GWConsolidated 3 → 1 + VPC endpoints
  • FinOpsTags, dashboards, anomaly detection
Beyond The Bill

What changed, permanently.

The 40% cut is the headline number, but the real outcome is the lasting practice. The team now runs cost reviews monthly, catches anomalies within 24 hours, and treats cloud cost as an engineering KPI.

$

Validated cost reduction

Every saving was validated against the AWS bill before sign-off. No projected savings. The CFO confirmed the new run rate at the end of month 3.

−40% / month
↑

Engineering velocity preserved

Deployment frequency, lead time for changes, and MTTR all remained within their pre-engagement bands. Cost optimization didn't slow the team.

0 regressions
⚡

FinOps culture installed

Per-team cost dashboards in Grafana, Cost Anomaly Detection routed to Slack, and a monthly cost review meeting between engineering and finance with a documented agenda.

Sustained 12+ months
⚙

Compliance posture maintained

ISO 27001:2022 evidence collection ran throughout. CloudTrail, multi-AZ, KMS, and Backup remained unchanged. No reduction in DR or audit capacity.

Audit-clean
SAVINGS
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★ AWS Advanced Tier Services Partner · ISO 27001:2022 · ISO 9001:2015 · 5× AWS-Certified Founder

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