Are longevity clinics worth it? A decision tree, not a verdict

Start with the part the sceptical coverage of this industry tends to skip. The conditions most likely to shorten your life do not announce themselves. About one adult in five carries an elevated lipoprotein(a), which is entirely genetic, completely silent, and something the 2026 cholesterol guideline says should be measured at least once in every adult.7 Hypertension, early kidney disease and atrial fibrillation are frequently asymptomatic too. Feeling well carries almost no information about any of them.

So the honest answer to whether you should get assessed is yes, and it is not a close call. The interesting question is the next one: assessed for what, by whom, and at what price. That is where the industry’s own answers stop being useful, because searching this question returns Fountain Life and Biograph writing about themselves. Nobody without a programme to sell had written it down, so the sellers did.

Here is the version from somebody with nothing in the category.

The question is about you, not about the clinics

Most coverage treats this as a question about whether the diagnostics work. That is the wrong frame. The diagnostics mostly work, in the narrow sense that a 3T MRI produces a real image and a laboratory returns real numbers. Whether a programme is worth its price depends almost entirely on your starting position, because the value of information is a function of what you did not already know and what you will do about it.

So: four questions, in order.

1. Have you used what you already have?

Germany gives statutory insurees a free health check every three years from age 35, covering blood pressure, fasting glucose, a full lipid panel, urinalysis, a hepatitis screen and a consultation.5 Most European systems have an equivalent. Cancer screening programmes sit alongside it, with their own eligibility rules.

Those measurements are the cheapest high-yield tests in medicine, and they are free. A meaningful share of the people who enquire about five-figure programmes have not had them. If that is you, the highest-value preventive appointment available to you costs nothing, and buying a premium programme first is spending €7,600 to learn your cholesterol.

If you have not used your statutory entitlement, start there and come back to this question with the results in hand. Not because a private programme is wrong, but because a €7,600 programme reading your cholesterol for the first time is paying a premium for something that was already free, and the numbers it returns are what tells you which tier you actually need.

2. What would you do differently with the result?

This is the question that decides most cases, and almost nobody asks it before booking.

If you already know you sleep badly, drink more than you should, and have not exercised properly since your thirties, a 230-biomarker panel will confirm it expensively. The information is not the binding constraint. Several thousand euros of diagnostics will not supply motivation that is not there, and the people who sell them know this even when their marketing implies otherwise.

If, on the other hand, you are the kind of person who acts on data, and you know it because you have done it before, then a result that shifts your behaviour has a value that is genuinely hard to price. That is a real answer, and it is different from peace of mind.

If the honest answer is that you would do nothing differently, the information is not your binding constraint and a larger panel will not become one. That is worth knowing before you spend, and it is a reason to spend differently rather than a reason to skip assessment: the cheap tests still answer the silent questions above, whatever you do with the rest.

3. Do you have an actual unanswered question?

Four situations where a comprehensive programme earns its price, and they are reasonably specific.

Strong inherited risk. A parent or sibling with early cardiovascular disease or a cancer that imaging can detect changes the arithmetic, because your prior probability is genuinely higher than the population average that guidelines are written for. This is the single best reason to buy depth.

A decade or more of avoidance. People who have had no meaningful medical contact since their twenties are the group where comprehensive workups most often find something that matters, for the obvious reason that nothing has been looked at.

Several connected problems nobody has joined up. Fatigue, disturbed sleep, creeping weight, borderline numbers on three separate visits to three separate doctors. Fragmented care handles this badly, and a single day where one physician sees everything at once is a structurally different service, not just a longer appointment.

A specific question with a specific test. You want to know your Lp(a), because it is genetically determined, measured once in a lifetime, and about one person in five has a level that materially raises cardiovascular risk. Buy the test. You do not need the programme around it.

If none of these describe you, the case for a comprehensive programme is weaker, and that is not a disappointing finding. It means the cheap things are working, and the sensible plan is the short list in section four rather than a five-figure package. Getting the silent measurements done still applies.

4. If you are buying, what should you buy?

Now the clinics matter, and the category divides more sharply than its pricing suggests.

The cheap end is the least scientifically adventurous and therefore the safest. Neko Health at £299 measures blood pressure, lipids, glucose and skin, which are the measurements with decades of outcome trials behind them, and declines imaging entirely. Nothing in it requires a leap of faith. The catch is a reported waitlist above 100,000 people and wait times of six to twelve months.

The imaging end is the most intuitively compelling and has the weakest outcome evidence. No randomised trial has shown that whole-body MRI screening reduces mortality in asymptomatic adults, and roughly a third of scanned people leave with a critical or unresolved finding.1 That does not make it worthless. It does mean anyone selling it to you on a survival claim has moved ahead of the literature.

The depth end assembles everything into one supervised day, and this is where the interpretation happens. A biomarker means one thing beside a clean image and another beside an abnormal one. Whether that is worth several thousand euros depends on whether a physician actually reads it all together, which is the question to ask before booking rather than after.

Two things to check on any price list

Where the modalities sit. Programmes tier by modality, not only by depth, and the marketing rarely makes this obvious. YEARS in Berlin is a useful worked example because it publishes the breakdown: Core at €1,900 buys 87 biomarkers with spiroergometry, echocardiography, vascular ultrasound, cognition and lung function, and contains no imaging, no liquid biopsy and no genetics. Whole-body MRI and a multi-cancer blood test arrive at €7,600. Genome sequencing and epigenetic clocks arrive at €16,900.6 Biograph in the US works the same way, holding its multi-cancer blood test back for the $15,000 tier rather than the $7,500 one.

Read the tier, not the range. A programme advertised from €1,900 may not contain the thing you are buying it for.

What the entry tier leads with. This is a better quality signal than the biomarker count. An entry tier built around a cardiopulmonary exercise test is doing more evidenced work than one built around a scan, because cardiorespiratory fitness has among the strongest mortality associations of anything measurable and whole-body MRI has none. Very few programmes are structured that way, and the ones that are have usually thought about it.

The short version

Get the silent things measured, whoever you are. Lp(a) once in your life, ApoB alongside your lipids, blood pressure properly, HbA1c with insulin, and your cardiorespiratory fitness if you can reach a test. That list costs a few hundred euros, has the longest outcome record of anything in this article, and most people reading this have not had it.

Then buy depth deliberately rather than by default. Once, early enough that a baseline is worth having, from a provider that publishes its prices and owns the follow-up, with the tier chosen for a question you can name. After that, cheap annual monitoring.

The one thing to be sceptical about is the annual five-figure subscription. Your genome does not change, your anatomy barely does, and the things that do move year to year are the inexpensive ones. A programme sold as a yearly ritual is charging repeatedly for measurements that only needed taking once.