It's mostly used so utilites can forecast growth in their areas for the next 25+ years and see the impact on their networks and feed into their capital work projects.
A decently sized utility may spend up to $200M/yr on capital works so $40k isn't even a line item!
There is completion in the market but consultants are forced to use what their clients pick and most utilites aren't that price sensitive.
There are also open source alternatives by the EPA[1][2], and most commercial operators are just wrappers around this public domain software.
I'm trying to create FOSS to help view and run these models.
[1] https://en.m.wikipedia.org/wiki/EPANET
[2] https://en.m.wikipedia.org/wiki/Storm_Water_Management_Model