DNA testing: the gene genie's out of the bottle
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From home DNA tests that link to our ancestry to physician-ordered tests that detect cancer genes, genetic testing has never been so affordable – or accessible – but what does this mean for life insurers?
Swiss Re Institute's report, "Can life insurance pass the genetic test?" provides insights and answers.
Christoph Nabholz, Swiss Re's Head Life & Behaviour R&D, is one of the authors. He reveals changing consumer attitudes towards DNA testing and the insurance industry.
Q: DNA or genetic testing has entered the mainstream in the last couple of years – nowadays it's common to see TV adverts for home kits. Was this a factor in launching the study?
A: Yes, we did indeed observe more and more activity in the media that was advertising DNA testing, particularly over the past two years. At the same time we witnessed genetic testing companies reaching out to the insurance industry, to offer their services as an add-on health management benefit to insurance customers. We saw these trends, but still needed a large sample group to ensure the statistical significance of the customer behaviour results. In the end, we surveyed 31,000 consumers, mainly in the US, and also Canada, UK, China and Australia.
Q: Why did you decide to include direct to consumer (DTC) tests as part of the survey when they do not impact life insurance as significantly as medical genetic tests done in clinical practice?
A: Given the big advertising campaigns for DTC tests – we wanted to explore why people undergo DTC genetic testing and what actions they take after they receive their results, including any physician conversations. We felt that further medical genetic testing could result from such conversations, and indeed the results confirmed that the DTC test is a natural "gateway" to more comprehensive medical genetic testing.
Q: What were the main surprises for you in the results?
A: The biggest surprise to me was the high genetic testing rate in the US – 20 percent of the survey population. Also, we assumed that a big reason for not taking a test was fear of discrimination by insurers if they get a bad result, yet this was cited by only four percent of respondents. Interestingly we found that those who had taken a predictive genetic test and learned they were at high risk for disease, were four times more likely to take out extra life insurance.
Q: As the price of testing comes down, and the desire for more knowledge about our genetic health rises, how can life insurers combat the risk of anti-selection?
A: In countries where regulators allow access to genetic testing results in the underwriting process, insurers could ask the applicants for the results. Interestingly the survey did show that 80 percent of people are willing to share their genetic data in return for a premium reduction or providing support to manage their health and even took positive health actions such as exercise to support this.
Q: The survey sample concentrated on five countries in established insurance markets. What differences did you observe?
A: Clearly the US was the leading genetic testing market. All other countries had fewer genetic testing rates in the survey population. One of the countries that stood out was China, where the acceptance of sharing genetic testing results with insurers was higher than in other markets.
For more articles on genetics from Swiss Re go to www.swissre.com/genetics