Diagnostics as a Service and longevity panel design: which biomarkers to offer

Diagnostics as a Service gives a longevity clinic more markers than it will ever sell in one panel, because over 2,500 orderable parameters are available across eight modalities at Aniva. Deciding where to stop is the harder half of the job, since the catalogue is rarely the constraint and the panel design usually is.

Founders usually start from which biomarkers the science supports, while the question that decides the business is which ones a clinician in your clinic can act on, because every other marker is a cost with a conversation attached.

None of this is legal advice, so a lawyer working in medical or competition law should review your own contracts and your website before you publish a panel.

What decides longevity panel breadth, the cost or the science?

Panel breadth is decided by unit cost, clinician time and whether a result changes what anybody does, because the science alone never says stop. There is always one more marker with a plausible link to ageing, so a panel designed by scientific interest grows until nobody can afford it or explain it.

Three costs rise with every marker you add, and only one of them is the analysis:

• The analysis itself costs money per marker, which is the cost founders model first.
• Explaining the result costs clinician minutes, which is the cost that limits how many customers a clinic can serve.
• Handling the questions afterwards costs support time, and the markers nobody can act on produce the most of it.

What a Diagnostics as a Service catalogue changes about breadth

A partner catalogue removes the equipment argument from the decision. You are no longer choosing between markers your analyser measures and markers it does not, so the choice becomes purely commercial and clinical, which is where it belongs.

That freedom has a cost of its own. When everything is available, the discipline has to come from your own rule about what a marker has to earn, so write that rule down before you look at the catalogue.

What is the difference between a screening tier and a deep tier?

A screening tier is one fixed list from one venous draw, sold to everybody at the same price with no consultation needed first. A deep tier is chosen after a screening result gave somebody a reason, adds modalities and sample types, and takes longer to analyse and longer to explain.

The two tiers are different products with different jobs. The screening tier exists to convert a stranger, so it has to be understandable in a sentence and available without a clinical conversation. The deep tier exists to carry margin, so it can be complicated, because by then the customer has a specific question and a person to ask.

Which eight modalities can a longevity panel use?

Aniva runs eight modalities, and each answers a different kind of question about the same person. Knowing which question each one answers is what stops a panel from measuring the same thing three ways.

• Clinical chemistry answers how the liver, the kidneys, the blood lipids and glucose handling are working at the moment of the draw.
• Endocrinology answers what the hormones are doing, which is where complaints about energy, sleep and body composition usually get their first real explanation.
• Nutrient status answers whether vitamins, minerals and fatty acids are where this person needs them, which is the modality behind test before you supplement.
• Immunology answers how the immune system is behaving, including inflammatory markers and antibodies.
• Genetics answers which fixed variants a person carries, and those results never change, so they are bought once.
• Transcriptomics answers which genes are being expressed around the time of the sample, so the answer depends on the person's state.
• Proteomics answers which proteins are circulating, which is a broader and newer read of much of the same biology.
• Microbiome answers what is living in the gut, and it needs a stool sample rather than blood.

What do normal reference ranges tell a longevity clinic?

A reference interval is built from a reference population and set to cover the central 95 percent of it, so a normal result means common in that group rather than good for this person. That is the standing critique behind optimal ranges, and it is correct as far as it goes.

Consider two people with the same result inside the same interval. One is at the bottom edge and improving, the other is at the top edge and falling, and the report calls both of them normal, which is the single most useful thing a longevity clinic can explain to a customer.

A laboratory accredited to ISO 15189 has to define the biological reference intervals and clinical decision limits it reports, and it has to review them periodically¹. The German quality guideline sets the internal control and external assessment requirements for the measurement itself². The fair half of the argument matters as much. An optimal range is often a clinical opinion supported by thinner evidence than the reference interval it replaces, so a clinic that publishes one owes the customer the reasoning and the source. Never present an optimal range as though a laboratory set it, because that is a claim the laboratory did not make.

The honest version is a value, an interval, a plain-language explanation and a trend across repeated panels, which is what the Aniva customer dashboard gives per marker. How much a given marker moves in the same healthy person from one day to the next is published per marker in the EFLM biological variation database³.

What happens to a longevity panel when you add more markers?

Markers a clinician cannot act on add cost, confusion and false alarms without adding value. The arithmetic is unkind: if a panel holds 100 markers with 95 percent reference intervals and those markers moved independently, roughly five results would be outside the interval in a perfectly healthy person.

Every one of those five produces a worried customer, an appointment and an explanation, so a wider panel buys you more support work than revenue without anybody choosing that. A German clinic also has limits on how it may talk about what a panel finds. Advertising a procedure to the public may not refer to detecting the illnesses listed in the annex to Section 12⁴. For people those are notifiable infections and malignant tumours, addiction disorders other than nicotine dependence, and pathological complications of pregnancy, childbirth and the puerperium. The carve-outs that matter to a clinic are in Section 12(2) sentence 2, and they are narrow.

The rule that survives contact with a real clinic is short. A marker belongs in a panel when a result outside the range changes the plan, and it belongs in the catalogue rather than the panel when it does not.

How should a longevity clinic tier its panels?

Tier by decision size rather than by marker count. The entry offer has to be a decision somebody can make alone in two minutes, and the deeper offer has to be a decision somebody makes with your clinician after a result gave them a reason to.

• Put one screening panel at the front, from one venous draw, sold at one price with no consultation required.
• Put the second tier behind a result, so it is chosen for a named reason rather than sold as the bigger option.
• Keep genetics separate, because it is bought once and it never needs repeating, which makes it a poor fit inside a repeating membership.
• Keep the rest of the catalogue available on request, since a specialist marker ordered occasionally costs you nothing when it is not ordered.

Three panels convert better than nine, because the customer at the front of your funnel is choosing whether to start rather than choosing between options.

How does the sample type decide what a longevity panel can contain?

Venous, capillary, saliva, stool and urine samples do not carry the same markers, so the collection method decides part of the panel before anybody chooses a marker. A venous draw supports the widest list, while a capillary kit provides a smaller volume and therefore a shorter one.

This is why collection is a product decision rather than a logistics decision. A founder who moves to an at-home kit to reduce cost has also changed what the panel can contain, and the customer sees that change as a smaller product rather than a cheaper one.

Collection methods a Diagnostics as a Service partner runs

Aniva runs six collection methods, which begin with a venous draw and a capillary kit and include saliva, stool, urine and an at-home kit. There are 25+ partner draw locations across Germany, so a panel that needs venous blood does not need a room in your own clinic. The partner offering is sold across Europe, while the consumer membership and the physical draw network are in Germany.

Ask any supplier which markers each sample type supports before you design the tiers, because that answer decides your product range more than the size of the catalogue does. Book a 30-minute demo at anivahealth.com/diagnostics to see the catalogue and the sample requirements together.

Notes and sources

Last updated: 31 August 2026

1. ISO 15189:2022, Medical laboratories, requirements for quality and competence. iso.org

2. Bundesärztekammer, Richtlinie zur Qualitätssicherung laboratoriumsmedizinischer Untersuchungen (RiliBAEK). bundesaerztekammer.de

3. European Federation of Clinical Chemistry and Laboratory Medicine, Biological Variation Database, searchable per marker. EFLM Biological Variation Database homepage

4. Section 12 Heilmittelwerbegesetz and the annex listing the illnesses public advertising may not mention. gesetze-im-internet.de and the annex