the health strategist
institute for strategic health transformation
& digital technology
Joaquim Cardoso MSc.
Chief Research and Strategy Officer (CRSO),
Chief Editor and Senior Advisor
November 13, 2023
This is an excerpt of the report below, focusing on the Executive Summary, and Chapter 1.
Roland Berger
Future of health 5
Morris Hossein, Thilo Kaltenbach,
Ulrich Kleipaß, Karsten Neumann and Oliver Rong
November 2023
Management Summary
Longevity is an age-old human aspiration that is recently enjoying renewed attention.
A wave of health-related innovations, such as GLP-1 agonists for weight loss, is transforming the market for products and therapies promoting a long and healthy life.
The power of healthy behaviors to improve lifespan is well known, but are health consumers actually more interested in novel products and therapies? How much are they willing to sacrifice to improve their health in old age? And who do they trust when it comes to their future health?
Our fifth annual Future of health study provides answers to these questions and more. As part of our research, we surveyed more than 2,300 people in 17 different countries,[1] asking them about their views and underlying motivations.
Our key takeaways are as follows:
- Quality preferred over quantity: Our survey shows that although people want to live longer, their preference is for quality of life over quantity of years. The true goal is to live not just a long, but a long and healthy life.
- Natural approaches are favored: People show a strong preference for natural approaches to ensuring a long and healthy life. Rather than taking drugs, 70 percent of respondents say they prefer preventive actions such as regular exercise and cutting calories.
- Trust in technology is growing: As evidence improves for new technologies and approaches, so interest in them will increase. Trust will grow in technology-supported approaches alongside traditional methods. This interplay between tradition and innovation will shape the future of health and longevity.
- A thriving market for a long and healthy life exists: The market is experiencing growing demand and will become one of the largest markets in the future, as aging affects everyone. The rapid development of innovative technologies and approaches will transform current health models and fundamentally alter markets as we know them today. This transformation affects everyone in the health industry.
- Players need to position themselves now: We recommend that players adopt a customer-centric approach, building networks and focusing on benefits and evidence. At the same time, achieving sustainable market growth relies on a number of key factors; for example, allocating aging an ICD code would lead to a major increase in budgets. Suppliers and providers also need to win over budget-holders, convincing them that treating aging will have a positive impact on the health conditions in aging societies.
Table of Contents
- 1.The future of health – Live long – and live well
- 2.A booming market – Rapid growth and vast potential
- 3. Consumer preferences – Focus on health and openness to innovation
- 4. Recommendations – An eye to the future
1 The future of health
Live long – and live well
Each year, Roland Berger’s Future of health study focuses on a topic of special relevance for the healthcare sector. For this year’s study, the fifth in our series, we surveyed more than 2,300 people from 17 countries around the world.
Our focus this time was on living a long and healthy life – in particular, how people think about extending their healthy lifespan and what they are willing to do for it.[2]
The desire to live a long and healthy life is nothing new, of course. The ancient Greeks knew that the value of life lay not only in its length, but also in remaining healthy into old age. This is reflected in the figure of Tithonus in Greek mythology, who was granted eternal life but not eternal youth, and so grew old and withered.
What can we do to extend our healthy life expectancy?
Apart from access to good healthcare, the scientific consensus is that we need to engage in healthy practices throughout our lives.
Regular exercise promotes cardiovascular health, muscle strength and overall wellbeing, reducing the risk of chronic diseases.
A healthy diet provides us with essential nutrients, supports our immune system and reduces the risk of obesity and chronic illnesses.
Stress management through meditation, yoga or relaxation methods contributes to better mental health and lowers the likelihood of stress-related ailments.
Social connections and a sense of purpose are equally important, according to researchers.
There is much that we can do to ensure that we do not follow in the mythical Tithonus’s footsteps.
Recent research has identified a number of “blue zones” – places around the world where life expectancy is significantly higher than average and people stay healthy into old age.
Researchers found that specific lifestyles, healthy habits and even the social and cultural environment lead to a longer, healthier life in these areas.
The four characteristic features shared by all blue zones have been formulated as follows:
- move naturally (by hand,[3] garden, walk);
- outlook (faith, purpose, unwind);
- eat wisely (moderate wine); and
- connect (family first, partnership, right tribe).
Educator and author Dan Buettner further suggests that the social and cultural conditions found in blue zones can be recreated anywhere; already, communities exist that are trying to replicate them in the United States, for example.
Another study that looked at more than 700,000 veterans in the United States found that individuals who adopt eight healthy lifestyle habits at the age of 40 – including not smoking, not using opioids, having a healthy diet and engaging in the healthy activities mentioned above – can enjoy a lifespan up to 24 years longer than those who do not. Not only that, these lifestyle changes brought significant benefits even if adopted at an older age.
Other studies have identified smoking as the factor with the biggest impact on life expectancy that individuals can influence.
Even stopping smoking between the ages of 50 and 60 can add six years to your life.
Education is also strongly correlated with life expectancy. In Germany, for example, the difference in life expectancy between individuals with the lowest and the highest levels of education can be more than six years.
Life expectancy has risen significantly over the past 200 years, except in periods of war, famine and infectious diseases, and is very likely to continue to do so.
This is largely due to advances in medical science, public health measures, new technology and changes in lifestyle.
While the maximum potential life expectancy of human beings has hardly changed for around 120 years, an increasing number of people are reaching a higher age, a phenomenon known as the “rectangularization” of the life expectancy curve.
A Life expectancy has been steadily increasing Global average, sample countries (1950-2021)
Source: OECD, WHO, Our World in Data
The gap in life expectancy between industrialized and non-industrialized countries has also narrowed over the last 70 years, partly due to the huge progress achieved in infant and child health.
In recent decades, however, the pace of increase has slowed, impacted by diseases such as COVID-19, health disparities, the rise in obesity, cancer and chronic diseases, sedentary lifestyles, mental health challenges and environmental factors.
Healthy life expectancy – the number of years an individual spends in good health – has also risen over recent decades. Yet it remains around nine years behind life expectancy.
In other words, roughly 1/7 (15%) of an individual’s life is lived in morbidity, that is, suffering from a medical condition or disease.
While some studies conclude that people are now living longer but not necessarily healthier lives, newer research reveals clear improvements in fitness for individuals compared to those at the same age a generation ago, at least among better educated groups.
There may be some truth in the claim that 70 is the new 60. A
New Technologies and Therapies
New technology can play a crucial role in increasing healthy life expectancy still further.
A wide range of innovative technological devices are appearing on the market, from non-wearable to wearable devices such as fitness trackers, smart watches, biosensors and wearable ECG monitors for detecting, preventing and managing disease or protecting health, to implanted devices.
As highlighted in our 2021 study Future of health 3, a company’s “reversal treatment” can prevent progression to type 2 diabetes in 97 percent of prediabetic patients. Digital coaching, training and tracking apps offer additional support for positive lifestyle changes that can have a life-enhancing effect.
Other emerging technologies are set to revolutionize the healthcare sector, from diagnostics assisted by artificial intelligence (AI) and personalized treatment plans to robotic limbs.
Advances in pharmaceuticals and other therapies are not far behind and include gene therapies and stem cell therapy.
New pathways to health include personalized medicine, in which healthcare and treatments are tailored to the individual’s unique genetic makeup, lifestyle and health status.
Another promising avenue is regenerative medicine and tissue engineering, which could lead to the development of new organs and tissues for transplantation, thereby addressing age-related deterioration.
People currently in good health can also benefit from innovations that aim to counter the effects of aging, from NAD+[4] boosters to senolytics.[5]
Other innovations in the field of anti-aging and longevity include hyperbaric oxygen therapy (HBOT), which is showing promising results in targeting aging hallmarks at a cellular level such as telomere shortening, and metformin, a drug used to treat type 2 diabetes but which studies show reduces all-cause mortality.[6]
Furthermore, recent research shows that obesity drugs such as semaglutide (GLP-1 agonist), as well as newer triple-G agonists (GLP-1, GIP and glucagon agonists), which are currently undergoing clinical trials, have shown remarkable results in weight loss, with individuals losing up to 15 kilograms over the course of 60 weeks, besides enjoying other cardiovascular benefits. Clearly, demand for such drugs will be high.
It is crucial to distinguish between novel therapies and conventional medicine, even where the latter employs cutting-edge, innovative approaches.
Conventional medicine fundamentally aims to diagnose and treat symptoms and conditions, while the market that we are interested in here offers treatments and technologies addressing aging and its underlying causes, improving individuals’ quality of life in absence of underlying medical conditions.
The biggest impact on healthy life expectancy remains behavior-based change.
According to AustralianAmerican biologist Dr. David Sinclair, just 20 percent of aging is determined by a person’s genes; the rest is due to lifestyle.
Sinclair believes that intermittent fasting, a plant-based diet, reducing stress, and regular exercise are the most effective methods for slowing down aging.
Caloric restriction, defined as lessening caloric intake without sacrificing essential nutrients, has also consistently shown the potential to extend healthy lifespan across various species in numerous studies.
Some questions remain when it comes to the specific lifestyle changes that contribute to healthier aging.
- Is high-intensity or low-intensity exercise more beneficial?
- Is a body mass index (BMI) below or above 25 conducive to health in older age?
- Does red wine help or harm longevity?
But whatever the answers to these specific questions turn out to be, one thing is clear: Combining behavior-based changes with new and existing technology and treatments makes it possible for people today not only to stay healthy, but actually to reverse the aging process to some extent. B
B Staying healthy with tech and behavioral change – Action-effect-evidence matrix
Source: Roland Berger
[1] Representative population sample with respect to age, gender and income structure in the following regions: Europe (Austria, Denmark, France, Germany, Italy, Netherlands, Spain, Sweden, Switzerland, United Kingdom), North America (USA, Canada), Middle East (Qatar, Saudi Arabia, United Arab Emirates) and Asia (China, Japan)
[2] The estimated number of years a person can expect to live is their life expectancy. In this study we focus on what generally healthy individuals can do to increase the number of years they enjoy a healthy life, or their healthy life expectancy; the related industry is known as the longevity industry. Although not the focus of our study, it should be noted that the most effective way to improve the life expectancy of any group of people is to improve the lives of the poorest subgroup
[3] “By hand” refers to hobbies carried out manually rather than using gadgets, which keeps the muscles and brain active.
[4] NAD+ (nicotinamide adenine dinucleotide) is a co-factor in cell energy transfer and is involved in protecting against aging factors, as well as promoting longevity by facilitating DNA repair and providing other cellular benefits. Its levels decline significantly with age.
[5] Molecules thought to be able to selectively target senescent cells
[6] Metformin has also generated considerable buzz as a potential “magic” weight-loss pill in recent times.
