The Average American Would Pay $242,000 For One Extra Year of Good Health

From one of the oldest known works of literature, The Epic of Gilgamesh, which chronicles a mythical quest for immortality, to today’s media fascination with young blood-transfusing biohackers, the notion of conquering aging has long captured our imagination. Conspicuously missing from this narrative, however, is an economic perspective: the monetary implications of curbing aging.  

In a recent paper written with economist Martin Ellison of Oxford University and biologist David Sinclair of Harvard Medical School, I calculated that an intervention that successfully slows down biological aging—lowering mortality and frailty at each age, such that U.S. life expectancy would increase by just one year—is estimated to be worth $37 trillion in net present value terms. That’s the equivalent of around $700 billion annually, more than 3 percent of the country’s entire GDP. 

These figures aren’t projecting what might happen to income levels; rather, the analysis measures what these health improvements are worth to us in dollar terms, otherwise known as our “willingness to pay.” Our calculation is based on two key ingredients: one’s quantity of life, or life expectancy, and one’s quality of life, as reflected in our health and standard of living. While these economic calculations reveal the enormous value in living longer, they also underscore that our long obsession with immortality is misguided. We need to shift attention from the pursuit of a longer lifespan (mere time) to healthspan (years of life spent in good health).  

Why “healthspan” matters more than lifespan

In the past, when the majority of people didn’t reach old age, health priorities and medical research focused on improving earlier years. In contrast, pre-COVID an estimated 71 percent of deaths globally were due to non-communicable diseases whose incidence correlates strongly with age, such as dementia, cardiovascular illness, cancer, and diabetes. This has created a new health imperative: not just to live longer, but to age “well” by slowing biological aging and thus reducing the frequency of age-related diseases.

 My research indicates that this mission is worth an enormous amount of money, both individually and collectively: A hypothetical intervention that increased life expectancy by just one year at birth is worth $118,000 to the average American—but an extra year of healthy life expectancy is worth $242,000. Living for longer is valuable, but the most valuable pursuit of all is ensuring that healthspan matches lifespan. This undertaking will have significant repercussions for a wide range of industries, far beyond pharmaceuticals and healthcare.

While the sheer dollar value of improving how we age is striking—a collective $37 trillion for an increase in life expectancy of one year; $367 trillion for a 10-year increase—the economic mechanisms behind these figures reveal a number of insights.  

That massive economic upshot derived from such a relatively modest improvement is a result of two factors. The first is how much we value health over wealth. That disparity has been magnified by Covid-19, when virus-curbing government policies and shifts in individual behavior produced a decline of 3.4 percent in U.S. GDP between 2019 and 2020.

The second factor behind this large estimated value is our progress to date in increasing life expectancy. Never before have we had a higher chance of growing old: A child born in high-income countries today is estimated to have a 50 percent chance of living into his or her 90s. In the U.S., the number of people aged 85 and older is set to rise from 6.7 million in 2020 to 19 million by 2060, and those aged 65 and older will increase from 56 million to 95 million. If the majority of people are likely to live into old age, then the value of aging well is enormous.

Our graying population has prompted speculation of an emerging “silver economy” aimed at meeting the needs of seniors. However, while consumers may be prepared to spend money on services in old age, our research indicates that they are prepared to spend more on aging well across their lifetimes, before they hit 65. We believe this will lead to the creation of an “evergreen” economy, which will cover a much wider demographic.

The economic case for aging R&D

Economically, treatments that successfully delay aging have two advantages over treatments focused on single, specific diseases. The first is simple aggregation: When age is a key factor in so many diseases, slowing biological aging has the potential to slow down the progression of multiple diseases, offering cumulative benefits. 

The second advantage of targeting aging, rather than addressing single diseases, is that it can unlock certain health synergies. For example, eradicating cancer would be a momentous achievement, but the economic value of doing so is restricted by the fact that our older years would still be marred by the risk of dementia and other diseases. If, instead, multiple diseases can be delayed, then our overall quality of life is higher. That makes targeting aging worth more—by our estimates, around two-thirds more—than the sum of its parts.  

Note that these are economic rather than scientific arguments. Scientific research into the pathways of aging includes using stem cells, removing senescent cells, reducing DNA damage, avoiding declines in protein maintenance, or prolonging the energy creation of mitochondria. But though scientific progress is being made, numerous hurdles remain. Research and development expenditure isn’t driven solely by the size of potential economic gains; investment is also influenced by the likelihood of success. Some of the existing barriers are scientific—the push to advance from lab tests to proven drugs, from worms and mice to humans. There are also major regulatory challenges, as interventions must be shown to be effective using the biomarkers of aging, rather than waiting decades to prove the efficacy of treatments. But though R&D into aging pathways is still nascent, our economic analysis indicates that spending in this area will increase in the years ahead as growing emphasis is placed on prolonging our healthspan. 

There is also a virtuous circle associated with improvements in how we age. For most diseases, the better the treatment, the less valuable future research becomes—but not so with aging. The more healthily people age, the more they value further gains to aging. In other words, if living into your 80s is spent in poor health, the value of extending life into your 90s is low. But if people are growing older free of disease and age-related ailments, living longer becomes more attractive.

The ripple effect of the evergreen economy

This raises a more important issue: how will society finance these longer lives and the required interventions? Just as improving health at earlier ages boosted GDP in the past, the same focus should now turn to healthy longevity. If we are to avoid the negative economic consequences of an aging society, a three-dimensional longevity dividend is required. We need to make lives not just longer and healthier but also productive for longer. Take, for instance, the education sector. In order to support longer working careers, especially in the face of technological change, we will need a major investment in the adult education sector. That will mean expanding higher education’s focus from those aged between 20 and 24 years (6.7 percent of the U.S. population) to those aged between 25 and 65 years (52 percent).

The financial industry will be affected, as well. Modern pensions were a 20th-century creation, as life became structured around three stages: education, work, and retirement. However, if age-slowing treatments are successful, longer working careers will be marked by multiple stages and transitions. As a result, long-term wealth management will be less focused on retirement and more on the risk of outliving one’s health, finances, skills, and relationships. 

The life insurance sector also has the potential to tap into the multibillion-dollar evergreen economy by tying together health and life insurance, offering payment for treatments. Tying wealth and health together is attractive for the individual, but also increases profitability for firms, as longer lives mean more premiums paid and delay when policies are paid out.

But the reach of the evergreen economy will extend even further. The food and beverage sector will come under increasing regulatory scrutiny as healthy aging becomes more important. Big data and AI will underpin a major component of preventative health, expanding the health tech sector. The government will be tasked with launching large-scale public health programs in support of healthy longevity, just as they were in the fight against infant mortality and midlife diseases. The list goes on.

Examining the value of aging through an economic lens illuminates in concrete terms why this topic is poised to become ever more important in the years ahead. It’s not just breathless stories of mouse blood, or advancements in the study of senescence, or evangelizing around nutritional doctrines such as caloric restriction. The pursuit of a longer, more productive healthspan will not solely be achieved by breakthrough biological treatments; how healthily we age is affected by a raft of decisions made throughout our lives. 

Society is beginning to realize this new imperative—to age well, not just longer—and the changes that shift will require. As that realization becomes more apparent and we start to tap into the $37 trillion (and growing) value of slowing aging, the evergreen economy will influence a wide demographic across multiple sectors. No one, no matter what industry they’re in, can afford to ignore the implications.

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  Andrew Scott is a professor of economics at London Business School. He coauthored The 100 Year Life, cofounded The Longevity Forum, and is a member of the WEF council on Healthy Ageing and Longevity.

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