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Back in middle school (~2008), Nike launched the Nike+iPod—arguably the first true "wearable" that tracked steps, pace, and distance. Fast forward 17 years, and we've entered the wild world of wearables: Apple and WHOOP now track blood pressure among countless other metrics, while Nutrisense monitors blood glucose and connects it to nutritional habits. These companies operate in the increasingly popular "longevity" space.

Recently, a new trend has emerged: direct-to-consumer labs. Wearable companies like OURA and WHOOP have integrated lab panels into their platforms, giving users visibility into their hormone levels, hemoglobin counts, and more. It’s worth talking about, now.

In this article, I'll explore the rise of direct-to-consumer lab testing, examine the market (competitors, size, business model), and assess its impact on consumers (patients), physicians, and the healthcare system.

The consumer lab testing market’s roots trace back to the early 2010s, with key milestones accelerating adoption through the 2020s:

By 2025, DTC lab testing is mainstream, with a robust ecosystem of startups, incumbents, and hybrid models, and a market valued in the billions.

The DTC laboratory testing market is experiencing significant growth globally. Valued at $3.4–$3.6 billion in 2024, the market is projected to reach between $5.9 and $8.1 billion by 2030–2034, with a CAGR of 8.9–10.9%. The U.S. leads this market, with $1.13 billion in 2024 (expected to reach $2.7 billion by 2034), and North America accounts for 40–47% of global revenue.

This growth is driven by increasing preventive health awareness, consumer demand for convenience, telehealth integration, reduced testing costs, and evolving regulatory frameworks. And if we consider the longevity market as a whole, it’s expected to hit $600B by the end of this year.

The DTC lab testing market employs several distinct business models to capture different consumer segments.

Subscription and membership services, pioneered by companies like Function Health, typically charge $499–$999 annually for comprehensive test packages with digital health insights and personalized recommendations.

Meanwhile, the a la carte model offered by Everlywell and LetsGetChecked allows consumers to purchase individual tests ranging from $49–$199, often with optional telehealth consultations for result interpretation.

Platform integration represents an emerging approach where wearable technology companies like WHOOP and OURA incorporate lab testing capabilities directly into their existing platforms, frequently as premium and add-on subscription features.

Regardless of consumer-facing model, most DTC testing companies rely on partnerships with CLIA-certified laboratories such as Quest Diagnostics and LabCorp for test processing and regulatory compliance, creating a complex ecosystem of specialized consumer interfaces built atop traditional laboratory infrastructure.

The direct-to-consumer lab testing space is building for the worried well—or more specifically, the worried well wealthy. These are high-income consumers who already have access to good care but want more testing, more data, more certainty.

And I get the appeal. I've been tuned into this world since my high school track and triathlon days, wearing a Garmin that tracked every metric imaginable. Now I wear WHOOP 24/7 and see the toll that night shifts and raising a kid take on my recovery. The insights are valuable. They motivate healthier habits. That's a win.

But as a physician, I find myself asking uncomfortable questions.

If these tools and comprehensive lab panels truly improved clinical outcomes, wouldn't we already be doing them in standard practice?

I don't know a single physician who wouldn't want to help their patients live longer, healthier lives.

We just don't have the data yet to say these approaches make a meaningful difference. Most routine checkups are well-covered by a CBC, BMP, lipid panel (with ApoB and Lp(a) when indicated), and A1c. But if an asymptomatic patient shows a mildly elevated inflammatory marker from a longevity panel—what then? Refer to rheumatology? GI? Chase a red herring? That's the bigger concern: unnecessary testing can trigger costly and unnecessary downstream workups.

For patients, the democratization of lab testing has real benefits. These services make health data accessible, promote proactive behavior, and can motivate lifestyle changes. Instead of waiting for an annual physical or dealing with insurance referrals, consumers can order comprehensive panels, track trends over time, and feel more in control of their health journey. The integration with wearables and AI-powered coaching creates a continuous feedback loop that feels modern and personal.

The downside is noise. When you're testing 50, 100, or 160 biomarkers on otherwise healthy people, you're going to find abnormalities. Many will be false positives or clinically insignificant findings that lead to anxiety, more testing, and unnecessary interventions. And for the 26% of adults who don't have a primary care physician, who's ultimately responsible for acting on these results? Does Function manage downstream care? Does it fall back on the patient to navigate the system? These are open questions.

From a physician's perspective, the longevity space creates a paradox. Isn't helping patients live longer and healthier lives already what we do? When I review CGM data, titrate GLP-1s, and manage chronic conditions—that's longevity, right? Or is that just…medicine? At some point, "longevity" starts to feel like healthcare rebranded for the wellness-savvy, cash-paying consumer.

But for independent physicians—especially those with direct care models—offering longevity panels might be a way to stand out. It's a clean, marketable product. Patients may not know what ApoB or Lp(a) is, but "Women's Comprehensive Hormone Panel" or "Longevity & Vitality Panel" has clear appeal. It packages something complex into something accessible.

The clinical challenge remains: what do you do with the results of 30 or 40 tests on an asymptomatic patient? For physicians rooted in evidence-based medicine, the flood of extra data can create more noise than signal.

From a health system perspective, the DTC lab testing boom raises serious questions about resource allocation and cost-effectiveness. These models are largely detached from clinical guidelines and cost-effectiveness analyses. What's the right cadence for testing? Are we scanning biomarkers yearly? Every three months? Who decides?

If we're serious about improving longevity at a population level, we should focus on the major drivers of morbidity and mortality: heart disease, cancer, diabetes, obesity. That means public health strategies, policy interventions, and evidence-based care—not just high-end testing for high-income individuals.

The DTC lab testing market, by contrast, risks widening health disparities. While affluent consumers get comprehensive biomarker tracking and personalized coaching, the uninsured and underinsured struggle to access basic preventive care. We're optimizing for individual consumers rather than society.

This brings me to the fundamental question (or tension): should longevity be a private good or a public one? Are we building solutions for individuals who can pay out of pocket, or for society as a whole?

Email me what you think!

In summary, the direct-to-consumer lab testing market offers convenience and empowerment for consumers willing to pay out of pocket, but its clinical utility for asymptomatic individuals remains questionable. For physicians, these services create both opportunity (for independent practitioners) and challenge (managing the noise from unnecessary testing). For the health system, the market risks exacerbating disparities and wasting resources on low-value testing rather than addressing the true drivers of longevity at a population level.