Baseline reports on preventive medicine: what the evidence supports, what the tests actually detect, and what the programmes cost. We grade the evidence behind every test we assess, and we publish the prices with a source and a date attached.
A recurring line in longevity clinic marketing, and a clean worked example of how a defensible measurement becomes an indefensible statement.
Neko built the best-designed cheap health check in Europe and cannot serve the demand. Wait times run six to twelve months. Here is what the alternatives actually replace, and what none of them do.
PATHFINDER 2 put Galleri through 35,878 people and produced the strongest evidence any multi-cancer blood test has. It also showed the test misses about six in ten cancers, and both facts are compatible with it being useful.
16 providers across 11 outpatient, imaging and membership programmes and 5 residential clinics, by entry price and modality coverage. Sourced, dated, and measured against the statutory check-up that costs nothing.
| Check-up 35 | €0 |
| Neko Health | £299 |
| Superpower | $499/yr |
| Function Health (with Ezra) | $499/yr |
| Prenuvo | $1,199 |
| Preventicum | ~€1,400 |
| OneMRI | A$2,990 |
Lanserhof, Clinique La Prairie, Fountain Life, Biograph and YEARS get grouped under one label and sold to the same people. Set their contents side by side and they turn out to be four different businesses, only two of which are really about diagnostics.
All three now operate in Europe, all three call themselves preventive health, and they overlap on almost nothing. A direct comparison of what each one actually measures, what it costs, and who each is genuinely for.
Every ranking of longevity clinics we can find withholds its methodology. So here are the criteria instead, applied to sixteen providers, with no winner declared. The criteria are the useful part anyway.
None of these require medical knowledge to test. Every one can be checked from a clinic's own website before you speak to anybody, and most of the category fails at least three.
Most guidance on this stops at a lipid panel. Most private programmes start several thousand euros past where the evidence runs out. Here is the sequence in between, with what each test is worth.
A coronary calcium score costs a fraction of a whole-body MRI, appears by name in the ACC/AHA cholesterol guideline, and reclassifies risk downward in about 40% of intermediate-risk people who score zero. In Germany it is also, as a pure screening test, not legally available.
Bone density scanning carries a guideline recommendation and moderate net benefit in older women. Premium programmes sell it as a body composition readout, which is a different test with a different evidence base.
The sensor is accurate, the data is real, and the evidence that wearing one changes anything for a metabolically healthy adult rests on seven small studies, only one of which measured an outcome.
The same diagnostic workup that costs $7,500 in San Francisco and sits inside a €25,000 Swiss week is available in Berlin and Essen for between €1,400 and €1,900. The reasons have more to do with how German medicine bills than with anything a marketing department decided.
Panel size is the number every premium programme leads with and the one that tells you least. Some of the additional markers change decisions, most add precision to a picture you already had, and a few mainly add things to worry about.
Direct-to-consumer gut testing has a reproducibility problem large enough to invalidate the product. Variation between providers analysing identical samples is as large as the variation between different people.
Epigenetic clocks are the most technically reproducible biomarkers in consumer longevity testing and among the least biologically stable. Repeated-measures work shows the two properties are unrelated, and that the most trusted clocks are the worst offenders.
Cardiorespiratory fitness predicts all-cause mortality more powerfully than almost anything else a clinic can measure, with no observed upper limit of benefit. It is also cheap, unglamorous, and buried on page four of most programme brochures.
Neko bets on frequency, Prenuvo on imaging, and the depth clinics on a single exhaustive day. These are not price tiers of one product. They are different theories of what preventive medicine is for.
Screening MRI sits at the centre of nearly every premium health programme in Europe and North America. No randomised trial has shown it reduces mortality in asymptomatic adults, and the evidence on what it costs the people it does not help is unusually specific.
Every private screening programme in Germany is priced against a statutory benchmark that almost none of them mention. Check-up 35 costs nothing, arrives every three years, and covers about eleven measurements. Here is the gap, itemised.