The best preventive screening in Europe, by criteria we will publish

Search for the best longevity clinic in Europe and you get four directories, each with a ranked list, none of which explains how the order was produced. One of them is scored out of 100. None publishes the weightings, the data source, or what would move a clinic up.

We are not going to add a fifth. What follows is the set of criteria we would apply, why each one is checkable, and how the European field divides on it. No winner is declared, and the reason is not diplomacy: a single ordering forces a seven-night residential programme and a six-hour diagnostic day onto one axis, and the resulting number is then quoted as though the axis existed.

Criterion 1: is the price published, per tier

Start here, because it separates the field before any clinical question is asked and because you can check it in a minute.

Publishing per-tier prices on their own site: YEARS, Neko Health, Prenuvo, Preventicum, Biograph. You can establish what you will pay and roughly what you get before speaking to anybody.

Publishing, but only inside downloadable PDF brochures: Lanserhof. Reported entry figures for seven nights including the Classic programme and the cheapest room run from about €5,390 at Lans, €6,480 at Sylt and €8,435 at Tegernsee,3 and different secondary sources give different numbers, which is what happens when a provider does not publish on a page.2

Not publishing: Clinique La Prairie, Chenot Palace, SHA Wellness, Palazzo Fiuggi, Q Bio, and Fountain Life’s lower tiers. Every figure available comes from third parties, and reported ranges are wide enough that the quote you receive may differ substantially.4

The correlation is worth stating plainly. The most expensive programmes in Europe publish the least about what they cost and what they diagnose.

Criterion 2: does the tier you are quoted contain the thing you want

Programmes gate modalities, not just depth, and marketing ranges obscure it.

YEARS publishes the breakdown, which makes it the clearest worked example rather than the most generous: 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 liquid biopsy arrive at €7,600. Genome sequencing, epigenetic clocks and microbiome analysis arrive at €16,900.7

Biograph works the same way in the US, holding its multi-cancer blood test back for the $15,000 tier rather than the $7,500 one.

The residential clinics generally publish no modality list of comparable specificity at any price, which means this criterion cannot be applied to them. That is itself the finding.

Criterion 3: is the entry tier aligned with the evidence

The single most useful quality signal we have found, and nobody markets on it.

Look at what the cheapest tier leads with. Cardiorespiratory fitness has one of the strongest mortality associations of anything measurable. Whole-body MRI screening has no randomised evidence of mortality benefit in asymptomatic adults and generates a critical or unresolved finding in roughly a third of people scanned.6

An entry tier built around a cardiopulmonary exercise test is therefore doing more evidenced work than an entry tier built around a scan, at any given price. Most of the category is arranged the other way, because a scan photographs better than a man on a bicycle wearing a mask.

Two European providers are arranged the right way round. YEARS Core includes spiroergometry and excludes imaging.7 Preventicum images only what the clinical picture indicates, which is closer to guideline radiology than anything else sold privately.5 They arrive at similar positions from opposite directions, one by tiering and one by principle.

Criterion 4: does anybody disclose test performance

Sensitivity, specificity and positive predictive value determine what a result means. A multi-cancer blood test at 39% all-cancer sensitivity is a good supplement and a poor reassurance product, and a patient cannot know which they are buying without the numbers.

One provider in the Index publishes them. YEARS runs a section stating that it discloses sensitivity, specificity and positive predictive value for its screening methods, that whole-body MRIs find abnormalities in many healthy people which would never have caused symptoms, and that asked whether the programme is study-backed the answer is only partly, with an undertaking to say where the evidence is thin.7

We looked for an equivalent from the other fifteen and did not find one. That is a statement about the category rather than an endorsement of one company, and it is the criterion we would weight most heavily if we were spending our own money, because a provider willing to publish the limits of its own product is telling you how it will present your results.

Criterion 5: who owns the follow-up, and do they also sell the treatment

A scan without an apparatus around it is a triage product delivered as a reassurance product. The question is whether a named physician owns what happens when something appears.

The related question is whether that physician’s employer also sells the intervention. Where diagnosis and therapeutics sit in one business the incentive gradient runs one way, without anyone acting in bad faith. Diagnostic-only models and externally referred treatment remove a judgement you would otherwise have to trust.

How Europe divides

Outpatient diagnostic days, Germany. YEARS in Berlin and Preventicum in Essen. Strongest on price transparency, modality disclosure and cost. This is also, on the numbers, the cheapest place in the world to buy a serious workup: €1,400 to €1,900 to enter, against $7,500 in the United States.

Imaging subscriptions. Prenuvo, with London since 2025. Transparent, narrow, and resting on the weakest evidence base in the category. Appropriate when the question is genuinely anatomical.

Sensor and blood, at scale. Neko Health at £299. The lowest cost per repeat visit in Europe by a wide margin, and the only product priced so that attending every year is a realistic decision rather than an aspiration. Everything it measures has decades of outcome trials behind it, so nothing in the product requires a leap of faith about screening efficacy. Its constraint is a waitlist above 100,000 people and wait times of six to twelve months.

It is worth separating two claims that get merged here, because they have different answers. On cost per repeat, Neko is unmatched. On evidenced modalities at an entry price, the answer is different: YEARS Core at €1,900 includes spiroergometry, which we grade B and which Neko does not offer, along with echocardiography and vascular ultrasound. Neko is the cheapest way to measure the well-evidenced basics repeatedly; the entry tier carrying the most evidenced modalities is the Berlin one, at roughly six times the price. Both are true, and which matters depends on whether you are buying a habit or a baseline.

Residential method clinics. Lanserhof, Clinique La Prairie, Chenot Palace, SHA Wellness, Palazzo Fiuggi. The most expensive tier and the least diagnostically legible. Judging them on modality count misses the point: they sell a behavioural intervention with medical supervision, and for somebody who will only change how they eat and sleep away from their own kitchen, that is a real product a diagnostic day cannot supply.

The criterion we would apply first

If you must reduce this to one question, use criterion 4. Ask a clinic for the sensitivity and specificity of the tests it wants to sell you.

The answer tells you three things at once: whether they know, whether they will say, and how they intend to present your results. Most of the field will not answer. That is the ranking, and you can produce it yourself in an afternoon.