Paying for your own longevity trial

Sarah Todd, a STAT reporter, was walking briskly on a steep treadmill in Chicago, wearing a mask she said evoked the villain Bane, while Prince crooned from an iPad speaker to keep her going. It was a VO2 max test, the last item in a $5,500 annual package at a longevity clinic affiliated with Northwestern University.

Her 6 October story reports that Northwestern Medicine, Weill Cornell and Mayo Clinic have all launched cash-pay longevity clinics. Weill Cornell's own price list reads like a gym membership with a medical school attached: $12,000 for a one-year programme, $7,500 for a baseline assessment, whole-body MRI and coronary CT as add-ons. STAT puts the top of the hospital market at $45,000 a year.

Critics point at the tension: these are nonprofit hospitals. A KFF analysis estimated their tax exemption was worth about $28.1 billion in 2020, against roughly $16 billion in charity care, as Medical Daily summarised.

So why would a hospital with a charitable mission sell a longer life by the year?

Four motives, one of them in the FAQ

The first motive is the obvious one: money. Cash-pay means no coder, no claim and no denial. After last week's edition on the AI billing war between hospitals and insurers, a customer who simply pays the invoice must look restful to a finance director.

The second is prestige, and on this one a hospital says it out loud. Northwestern's donor brochure promises that through its longevity institute “Northwestern will be recognized as one of the leading institutions in the world in the field of human aging and longevity”, next to a menu of naming rights: $10 million for a centre, $3 million for a professorship. A client who spends $5,500 a year on a check-up is exactly who a development office hopes to meet.

The third motive people suggest is recruitment. The only trace I found is a Mayo Clinic job ad that sells the post as “a unique opportunity to contribute to an innovative and emerging area of care”, with time for research. There's no hard proof that doctors join or stay because of it, but it's easy to see a post sold as new territory pulling in applicants a standard clinic job wouldn't.

The fourth sits on Weill Cornell's FAQ page, under the question about insurance. The programmes are elective and not covered, and “one of our goals is to demonstrate the clinical value of this approach so that longevity-focused care is eventually recognized and reimbursed by insurers.” Northwestern said something similar when its clinic opened to the public in July 2025. Its medical director, Baljash Cheema, put it plainly: “We have tests that are not typically done in a routine clinic, they're done in research studies.” The institute's director wants identical labs around the globe to find interventions that slow ageing.

Read those quotes side by side and the cash-pay clinic starts to look like a clinical trial with the money flowing the wrong way: in a normal study the hospital pays the participant, here the participant pays the hospital.

Compare that with a longevity-adjacent product that already has the evidence. In What is bigger than AI?, Azeem Azhar and Hannah Petrovic of Exponential View report that GLP-1 drugs sold $76 billion in 2025, more than the $63 billion they estimate for generative AI. Semaglutide also has the kind of trial a biological-age test can only hope for: in SELECT, 17,604 people with overweight or obesity and existing cardiovascular disease had a 20% lower risk of heart attack, stroke or cardiovascular death than those on placebo. They were already ill, so it's no licence to prescribe for a longer life, but the price lists above have nothing like it. And the hospitals aren't the ones collecting. Novo Nordisk has sold Wegovy straight to cash-paying patients since March 2025, first at $499 a month against a $1,349 list price, and for less since. Neither Weill Cornell's nor Northwestern's programme page mentions the drugs; the closest I found is a GLP-1 companion programme that Mayo sells to organisations through its diet business.

Nor has that evidence turned into savings. An NBER study of insurance claims found no drop in other medical spending over five years of GLP-1 use; each dollar spent on the drugs came with 22 cents of extra spending on other care. If a drug with SELECT behind it can't yet show an insurer savings, the whole-body MRI on Weill Cornell's price list has a long way to go.

Same word, two business models

On the same day STAT published, Northwell Health launched an Institute for Healthy Aging across its 28 hospitals. It's built on the geriatric 4Ms framework and aimed at a state where more than 17% of people are over 65. The word on the door is the same and the customer is the opposite: one serves people who can pay, the other a population that is already ageing.

Questions for everyone at the table

If you're a patient, ask which test will change a decision you'd make. Radiologists' own professional body doesn't recommend whole-body MRI for people without symptoms, and the bill for the follow-up scan after an ambiguous finding rarely appears on the price list. Both Northwestern and Weill Cornell route suspicious findings to their own specialists, which is good care and also a feeder into the rest of the hospital.

If you sit on a hospital board, European ones included, write down which of the four motives is yours before anyone designs the pricing page. If the answer is evidence, behave like a research programme: publish the protocol, the outcomes, and the tests you dropped because they didn't change anything.

If you're a payer (in the US an insurer, in most of Europe the sickness fund or the committee that grants a reimbursement code), Weill Cornell is telling you it wants your money eventually. Tell them now which outcomes would earn a code or a contract, so the data gets collected in a form you'd accept.

Europe has the trend too, in a different shape. In Spain, the private group Quirónsalud runs longevity units, and one of them says its hyperbaric chamber can lengthen telomeres by up to 35%. In Italy, Rome's academic Gemelli hospital ran free longevity check-ups at a mountain resort this summer, with more than 1,000 screenings in a single week. Clinicians from Mayo, Sheba and Singapore explained in a 2024 GeroScience paper why public hospitals hesitate: “at publicly funded hospitals, codes for billing insurance have to be identified or other models have to be introduced.” In Belgium and the Netherlands I've only found classic executive check-ups. The conferences where this argument will play out next are on Longevity Events.

💥 May this inspire you to ask who the evidence is for before you ask what it costs.