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Medical advancements that could benefit insurers?

09 May 2017 Jonathan Faurie
Dr Adela Osman, Chief Medical Research Officer RGA Reinsurance Company of South Africa

Dr Adela Osman, Chief Medical Research Officer RGA Reinsurance Company of South Africa

For many years, medical research had a direct impact on medical schemes as medical advancements result in better care being received by patients. Very few of us realise that medical advancements, and precision medicine in particular, is having a direct impact on the life industry. FAnews spoke with Dr Adela Osman, Chief Medical Research Officer RGA Reinsurance Company of South Africa, to find out more about its impact.

What is precision medicine?

On a basic level, precision medicine is a medical model that proposes the customisation of healthcare, with medical decisions, practices, or products being tailored to the individual patient. On a more involved level, this involves specific tests to find out whether a patient runs the risk of developing cancer or cardio vascular diseases, and then taking appropriate steps to manage treatment to cure the disease or maintain a liveable lifestyle.

But how has precision medicine impacted managing cancer and cardio vascular diseases? “There is a lot of work being done at present around a single blood test to detect all forms of cancer at a very early stage, and these initiatives have the support of major players including Bill Gates and Jeff Bezos. If these visions are realised, it could have a significant impact on the underwriting of cancer in the future, and it could also alter the way in which insurers assess cancer claims. Possible applications include early detection of cancer as well as the ability to monitor residual disease and the response to treatment, and to identify high-risk recurrences,” says Dr Osman.

She adds further that tumour sequencing allows for the detection of specific mutations of a cancer, and these results determine the best type of treatment and influence long-term outcomes. Tumour sequencing may become the standard of care in oncology in the near future and allow for personalised care.

The impact on the industry

The above information is high level information on how precision medicine is impacting the medical industry. But how is it impacting the life insurance industry?

"Precision medicine provides more accurate risk assessment and disease management, and pharmacogenomics – individualised drug therapies that are based on a patient’s genetic profile – allows for individualised therapies that give the right medication at the correct dosage and which are aimed at specific targets which indicate the likelihood of a patient developing cancer. These therapies are fairly new in clinical practice, so their full impact on the insurance industry has not been realised as yet. However, many areas of the insurance industry could be affected by developments in precision medicine, but this will depend on what the regulations allow,” says Dr Osman.

For example, genomics and precision medicine could enable insurers to enhance risk stratification to attract healthier applicants. It could potentially be incorporated into a wellness benefit (after a policy is issued) to give clients a better understanding of their heath and risk factors and thereby motivate healthy behaviour.

“At claims stage, cancer tumour testing and pharmacogenomics could improve outcomes and reduce treatment side effects. Health reimbursement benefits may also be impacted in this new environment; pharmacogenomics testing could reduce the cost of medications and the number of long-term hospital stays," says Dr Osman.

The role of the insurer

So we now know that there will be a significant impact on the life insurance industry. But what role do insurers play in embracing precision medicine?

“Some life insurers have partnered with Human Longevity (HLI), an organisation using advanced genomic based information to evolve the practice of medicine to be more proactive, personalised and preventive. HLI combines DNA sequencing/analysis with machine based learning to assess risk and to develop useful insights into medicine. These learnings could ultimately lead to new therapies, personalised healthcare plans and healthier, longer lifespans. All of these factors have a bearing on the life insurance industry,” says Dr Osman.

Precision medicine can benefit life insurers immeasurably. Dr Osman adds that the technology around genomics and precision medicine is advancing rapidly, and genetic testing is becoming more common.

“Genetic testing can reveal that an otherwise healthy individual has a higher predisposition to developing a specific disease at some point in the future. This information could be used to affect decisions regarding insurance by both the consumer and insurers. Therefore, by being part of the development of regulations related to precision medicine, life insurers could ensure that the needs of the insurance industry and clients are taken into account when regulations are designed. However, the regulatory environment is very complex, and this could have a significant impact on the insurance industry and how it deals with anti-selection and the pooling of risk,” concludes Dr Osman.

Editors Thoughts:
How the life industry reacts to precision medicine will be crucial.  People take out insurance to make sure that they and/or their families will be able to survive after a diagnosis or incident. When specific illnesses or incidents are excluded, or loaded to such an extent that you cannot afford it, based on genetic testing, what is the point of taking out the cover? Is this something we should be concerned about? What does the future hold? Please comment below, interact with us on Twitter at @fanews_online or email me your thoughts

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