What longevity clinics sell, and what science has shown - critical summary review

Longevity medicine starts from an idea that sounds simple and is not: instead of waiting for diabetes, heart disease or cancer to show up and treating each one separately, medicine could act on the biological processes of ageing that feed all of them at once. The goal is to add healthspan, the years of life spent in good health, and possibly lifespan itself. "Aging has biology. This biology drives diseases," Nir Barzilai, director of the institute for aging research at Albert Einstein College of Medicine in New York, told CNN.

That biology now has a map. Scientists describe ageing at the cellular level as twelve interconnected processes, collectively called the hallmarks of ageing, which include genomic instability and chronic inflammation. Much of the research works by comparison: a standard question in the field is what a bowhead whale and a naked mole rat have in common, and the answer is very long lives and remarkable resistance to cancer. Researchers have identified genes that regulate those processes, and manipulating them in animals has improved health and function in older animals. In some cases it has extended their lives.

That is the backdrop against which the current boom arrives. The science is real, the animal results are repeatable across labs, and the money has moved far ahead of both.

What the clinics sell

There are roughly 800 longevity clinics in the United States, according to a June 2024 estimate from the American Academy of Anti-Aging Medicine. A first session typically involves blood and metabolic testing, a VO2 max test to gauge fitness, and a "biological age" reading that some in the field describe as a credit score for the body. Clinics measure biomarkers such as inflammation levels, immune health and cognitive ability, then recommend personalised therapies, supplements and nutrition plans.

The prices climb from there. Intravenous drips, from multivitamins to minerals like magnesium, run from $150 to more than $1,000 per session according to listings on some clinics' websites. Andrea Maier, director of the National University of Singapore Academy for Healthy Longevity and founder of the Singapore clinic Chi Longevity, told CNBC that for the popular NAD+ drips in particular, "there's really no biology behind" them. Elective full-body scans range from $1,000 to more than $3,000. Matthew Davenport, a radiologist at the University of Michigan Medical School, told CNBC that when such scans are done without a medical reason, "in many cases, they lead to downstream harm, even though you think you're helping the patient," because incidental findings trigger follow-up tests, endoscopies or surgery.

Memberships sit at the top. The luxury gym chain Equinox sells an "Optimize" plan with personal training, sleep coaching and a health concierge for $40,000 a year, with a waitlist of over 1,000 people according to a company spokesperson. Human Longevity, with sites in San Diego and San Francisco, charges $8,000 to $19,000 a year. In New York, the clinic Extension Health offers an invite-only "Superhuman" package at $250,000 a year that can include plasma exchange, in which blood is removed, separated from substances such as abnormal proteins, and returned to the body.

Where the money is going

In the first quarter of 2026 alone, longevity biotech companies raised approximately $3.74bn, and a recent Forbes article called the field the billionaire's next big bet after artificial intelligence. Two successes explain much of the enthusiasm: the AI boom, and the commercial performance of the new obesity drugs, which are among the ten best-selling medicines in the world and worked on a problem that was widely considered to have no shortcut. The reasoning in the market is straightforward. If something as complex as obesity turned out to be treatable, why not ageing.

The demographics point the same way. In 2026, people aged 60 or over account for 27% of global consumer spending, around $19 trillion, according to a joint study by World Data Lab, NielsenIQ and Silver Economy. The wider wellness market is forecast to reach $9.8 trillion by 2029, up from $6.8 trillion in 2024, according to the Global Wellness Institute.

What science has shown, and what it has not

In the lab, researchers have manipulated the biology of ageing in organisms from roundworms to mice, using medicines, exercise and calorie restriction, and extended their lives. In people, the picture is different. Daniel Belsky, associate professor of epidemiology at Columbia University's Mailman School of Public Health, told CNN that the central hypothesis has not been tested in humans. "We don't know yet whether we can really do this. But we do have an alignment of evidence to argue this is possible. And we now have a mobilization of resources to actually test it," he said. "For humans, we do not yet have clinical trial evidence that intervention on this biology to extend health span is possible."

The obstacle is time. Belsky said a trial testing whether an intervention taken at 40 or 50 prevents chronic disease might have to follow participants for two or three decades. That is why researchers are hunting for biomarkers reliable enough to serve as surrogate endpoints, measurable signs that a real health outcome will follow. The link between moving those markers and actually extending healthy life has not been established.

Regulation is the other gap. The Food and Drug Administration does not currently treat ageing itself as a disease target, so companies must show benefit against specific diseases or measurable aspects of health. Side effects are largely unknown, because trials are early. One branch of the field aims to manipulate DNA repair, but antibody-producing B cells deliberately introduce mutations into their own DNA in order to make effective antibodies, and it is not clear what such a therapy would do to a patient's immune system. Decades of clinical research have shown that altering one part of the body tends to disturb another: antibiotics change the microbiome and select for resistant bacteria, chemotherapy kills healthy fast-dividing cells.

Clinics are multiplying anyway. The Mayo Clinic launched its Healthy Longevity Clinic in 2023, and Singapore's National University Health System runs a similar programme. Some scientists have cautioned that the field needs better regulation. In October 2024, Abu Dhabi's Department of Health introduced a licensing framework for Healthy Longevity Medicine Centers, which it described as the first of its kind globally, and licensed the Institute for Healthier Living Abu Dhabi as the first state-designated centre of the type.

What already has evidence and costs almost nothing

Belsky's point is that the proven part of the field is not for sale. "The thing we know works is available in some form to most of us," he said, pointing to sleep, exercise, community and diet. "We can add healthy years to our lifespan even without these new drugs." Many longevity doctors give the same unglamorous advice: move, eat whole foods, spend time with people you love.

Even a dog counts. Dan Buettner, founder of the Blue Zones organisation in Minneapolis, said on his podcast that dog ownership may be the single most effective addition to a life, because "a dog forces you to walk every day, gives you a purpose and provides unconditional love." Research published by the American Heart Association in its journal Circulation associates dog ownership with a 24% reduction in all-cause mortality, rising to as much as 33% among people who have already had a heart attack or stroke. Studies in BMC Public Health found dog owners walk an average of 22 more minutes a day, and a 12-year Swedish study of 3.4 million participants found lower blood pressure and less cardiovascular disease among them. The US Surgeon General has declared chronic loneliness a public health epidemic, comparing its risks to smoking 15 cigarettes a day.

What to do with this information

Before paying for a protocol, a scan or a membership, ask what human clinical evidence supports that specific intervention. Promising biology in mice is not proof in people, and the field's own researchers say so plainly. Maier's advice is to spend only on therapeutics with evidence behind them, and to establish through testing and a physician whether your body needs something before trying it. Sanjiv Lal, CEO and co-founder of the clinician platform Regen Therapy, told CNBC that "the most wasteful thing that we can do in this space is to try things without measuring them." If you want a cheap entry point, Maier suggests starting with a blood test that shows what your body lacks, or a gut microbiome test, which at home runs roughly $200 to $500. "Start with the basics," she said. "The best return of investment is actually there."

The markers worth following are regulatory and clinical, not commercial: whether the FDA begins to recognise ageing as a treatable target, and whether long-term trials produce results. Funding rounds measure appetite, not efficacy.

Looking at what you already spend on your health, how much of it rests on evidence you could actually point to?