人寿保险承保中的遗传风险评分。

Genetic risk scores in life insurance underwriting.

作者信息

Karlsson Linnér Richard, Koellinger Philipp D

机构信息

School of Business and Economics, Vrije Universiteit Amsterdam, De Boelelaan 1105, Amsterdam 1081HV, the Netherlands; Department of Economics, Leiden University, Steenschuur 25, Leiden 2531ES, the Netherlands.

School of Business and Economics, Vrije Universiteit Amsterdam, De Boelelaan 1105, Amsterdam 1081HV, the Netherlands; La Follette School of Public Affairs, University of Wisconsin-Madison, 1225 Observatory Dr., Madison, WI 53706, USA..

出版信息

J Health Econ. 2022 Jan;81:102556. doi: 10.1016/j.jhealeco.2021.102556. Epub 2021 Nov 15.

DOI:10.1016/j.jhealeco.2021.102556

PMID:34847443

Abstract

Genetic tests that predict the lifetime risk of common medical conditions are fast becoming more accurate and affordable. The life insurance industry is interested in using predictive genetic tests in the underwriting process, but more research is needed to establish whether this nascent form of genetic testing can refine the process over conventional underwriting factors. Here, we perform Cox regression of survival on a battery of genetic risk scores for common medical conditions and mortality risks in the Health and Retirement Study, without returning results to participants. Adjusted for covariates in a relevant insurance scenario, the scores could improve mortality risk classification by identifying 2.6 years shorter median lifespan in the highest decile of total genetic liability. We conclude that existing genetic risk scores can already improve life insurance underwriting, which stresses the urgency of policymakers to balance competing interests between stakeholders as this technology develops.

摘要

预测常见疾病终身风险的基因检测正迅速变得更加准确且价格亲民。人寿保险业有兴趣在承保过程中使用预测性基因检测，但还需要更多研究来确定这种新兴的基因检测形式是否能比传统承保因素更优化承保流程。在此，我们在《健康与退休研究》中，对一系列常见疾病的基因风险评分和死亡风险进行了生存Cox回归分析，且未向参与者反馈结果。在相关保险场景中对协变量进行调整后，这些评分可以通过识别出总基因风险最高十分位数人群的中位寿命缩短2.6年，来改善死亡风险分类。我们得出结论，现有的基因风险评分已经可以改进人寿保险承保，这凸显了政策制定者在这项技术发展过程中平衡利益相关者之间相互冲突利益的紧迫性。