How Diagnostics Can Power The Longevity Revolution

Longevity is redefining healthcare strategies across every part of the industry. The focus is shifting from treating disease at its end stages to proactively preserving health and function across a longer lifespan. This new approach centers on molecular resilience — the body’s ability to adapt to stress and maintain function with age. It is not simply about adding years, but about ensuring those years are healthy, independent, and productive.

The imperative for leaders to adapt to this mindset has never been more pressing. By 2050, one in six people will be 65 years of age or older and life expectancy will climb to 77, up from 46 in 1950, according to the World Economic Forum and Mercer. As populations age though, so do the rates of chronic conditions — more than half of people 60 years of age or older have multiple chronic conditions. Remarkably, 70%-80% of chronic conditions in older adults are preventable. This presents a unique opportunity for health systems: invest in predictive prevention, leverage early screening for high-risk groups, and intervene with lifestyle or medical solutions before disease takes hold. Effective management of cardiovascular disease, diabetes, and cancer can improve individual outcomes and free up essential healthcare resources for those in greatest need.

Central to this transformation is early diagnosis. Expanding access to high-quality testing — particularly through decentralized and direct-to-patient channels — enables health systems to intervene earlier and more effectively. At the same time, advances in transformative medicines are starting to reverse disease trajectories, restoring health where possible. Achieving this vision requires a shift in mindset: aging must be viewed as a strategic opportunity for investment, not a burden. It also calls for coordinated action across sectors to foster a holistic lifecare model, where healthy aging is measured by the capacity to function, adapt, and thrive — not just survive. Interest is building to support this approach as the longevity industry is projected to be worth $600 billion by the end of 2025, up from $25 billion in 2020.

Diagnostics: The Enabler of Sustainable Longevity

Diagnostics are foundational to this new model of health. Their role is especially clear in the management of metabolic health, which remains one of the most significant burdens on global healthcare systems. By continuously monitoring metabolic biomarkers — such as glucose variability, insulin sensitivity, inflammatory markers, and lipid profiles — diagnostics enable the early identification of individuals at risk for conditions like type 2 diabetes, cardiovascular disease, or obesity-related complications.

Roche is actively developing integrated platforms that combine diagnostic testing with digital tools to generate longitudinal health data. These solutions allow for precise risk stratification and proactive intervention, supporting clinicians in tailoring preventive strategies while empowering individuals to take greater control of their health. By embedding such approaches into routine care and population-level screening, diagnostics can become the backbone of sustainable chronic disease management — extending health span and easing long-term pressures on healthcare systems.

As longevity trends accelerate the shift from acute to chronic and non-communicable diseases worldwide, innovative diagnostic and prevention strategies are more critical than ever.

Tailoring Diagnostics to Diverse Health Systems

Diagnostic needs and value propositions differ widely across countries, shaped by demographic and economic realities.

• In developed Western countries with stable reproduction rates, the focus is on securing reimbursement for advanced diagnostics and integrating them into value-based care
• Developed countries with low fertility rates frequently implement government-funded annual health check-ups and procure diagnostics through tenders, emphasizing preventive care and cost efficiency
• In low- and middle-income countries (LMICs), improving access to essential diagnostic technologies is a top priority, often in the face of resource constraints

These differences highlight the necessity for flexible, locally tailored solutions. Roche’s cervical cancer screening initiative is a compelling example. The program combines HPV testing with an integrated digital decision-support platform and offers a self-collection option, making it accessible to unscreened women, particularly in rural or hard-to-reach areas. By empowering women to manage their health, the initiative addresses privacy, comfort, and cultural barriers that often limit participation in traditional screening programs. The result is higher screening rates and earlier detection of pre-cancerous lesions, ultimately preventing the progression to cervical cancer. This patient-centered approach exemplifies how diagnostics can drive equitable, scalable, and sustainable improvements in population health.

Trend towards Cost-effective Solutions in Diagnostics Spend

Medical imaging usually springs to mind when people think about diagnostics — X-rays, MRIs, and CT scans. But in vitro diagnostics, which include tests that can be done at home, in a clinic, or a lab, have a larger market share. The global IVD market is about $97 billion, compared to $47 billion for imaging. IVD’s lead is largely due to recurring revenue from reagents and its central role in routine testing. The spending balance may shift modestly in favor of imaging in the next five years though as the use of artificial intelligence to read scans accelerates.

The diagnostics landscape is expected to move further toward integrated, cost-effective solutions in Western countries as value-based healthcare continues to take hold. IVD, combined with algorithmic decision support, can significantly streamline clinical workflows, especially in environments with limited access to advanced imaging. For example, ColonFlag, an IVD plus algorithm-based tool, analyzes routine blood test results to identify individuals at elevated risk of colorectal cancer. By flagging patients who would benefit most from further investigation, such as colonoscopy, this approach optimizes the use of imaging resources, supports early detection, and expands access to preventive care — especially in underserved or resource-constrained settings.

The Future of Diagnostics: Continuous, Multi-Omics, and AI-Driven

Diagnostics are evolving rapidly, moving from static, point-in-time assessments to continuous, longitudinal data collection and analysis. Several technological advances are driving this transformation:

• Multi-omics approaches — including proteomics, metabolomics, and lipidomics — are now being leveraged for sensitive biomarker detection, enabling earlier and more targeted preventive interventions. Although not yet mainstream, multi-omics represents the next frontier in precision diagnostics
• Next-generation sequencing is central to identifying health risks before symptoms appear. Scalable sequencing platforms are being developed to expand access to genomic insights and support more affordable, decentralized approaches to preventive screening and risk assessment
• Decentralized, multi-modal diagnostic platforms are bringing advanced testing closer to patients. Compact devices capable of performing antigen, antibody, and molecular assays provide rapid, actionable insights in a range of settings — from homes and retail clinics to primary care and remote locations
• Digital twin technologies are emerging as powerful tools for preventive care. These dynamic, data-driven models simulate an individual’s biology over time, integrating omics data, clinical history, and behavioral metrics to forecast disease risk and inform real-time decision-making. Such models will ultimately help clinicians test and simulate interventions before disease progression occurs

Collectively, these innovations mark a shift from reactive diagnostics to anticipatory, personalized health management, accelerating the transition to more proactive, prevention-focused healthcare systems.

Unlocking the Value of Prevention with Targeted Reimbursement Strategies

Despite their long-term benefits, prevention and early diagnostics often face reimbursement challenges. While government and employer-sponsored programs cover a significant share of diagnostic reimbursements, incentives frequently prioritize low upfront costs over high-value, long-term outcomes.

To bridge this gap, innovative reimbursement strategies are emerging. Public-private pilot programs, partnerships with life insurers, and outcome-based contracts are aligning incentives around concrete metrics. Notably, mechanisms such as tokenization and social or health impact bonds are gaining traction, offering performance-based financing frameworks where investors are repaid based on achieved health outcomes. These approaches unlock new sources of capital and promote accountability, paving the way for scalable and sustainable adoption of high-value diagnostics.

Life insurers are increasingly interested in diagnostics, recognizing that healthier insured populations mean reduced claims and improved profitability. However, as the use of diagnostic data grows, it is essential to ensure that individuals are not unfairly excluded or penalized. Transparent regulation and robust safeguards are vital to maintain equity and public trust.

Toward a Lifecare Model

The longevity revolution calls for more than incremental change. It requires a fundamental rethinking of health management — one that prioritizes resilience, prevention, and personalized care. Diagnostics are at the heart of this transformation, enabling earlier, more targeted interventions and supporting sustainable, high-quality healthcare for all.

Achieving this vision will require strategic investment in innovation, new funding models, and coordinated action across stakeholders. By embedding early detection, continuous monitoring, and equitable access into health systems, we can redefine healthy aging — not as mere survival, but as the sustained capacity to function, adapt, and thrive at every stage of life.

Disclaimer for Alexandra Vallon Eberhard: This paper is based on my personal views and does not reflect the position or policies of my employer F. Hoffmann-La Roche Ltd.