The NHS is currently working on a genetic testing project. Kerry Nicolaides asks what implications this would have for the protection industry
The practical application of science has typically had the reputation of being inaccessible, costly or limited to the minority who could actually understand its complexities. Against this background, I am incredibly impressed by (but also slightly apprehensive about) the work the NHS, fully backed by the government, is doing in genetic testing. It is potentially world leading.
The NHS’s genome project, intends to conduct full genome sequencing of 100,000 patients over a three- to five-year timescale. The patients will have their entire genetic make-up mapped, with the objective of identifying whether they are carrying a particular mutation or are at risk of developing a particular genetic condition.
The government hopes the programme could revolutionise the treatment and prevention of diseases such as cancer and heart attack, and assist in finding genetic keys to fighting obesity or diabetes.
The cost of such tests has plummeted dramatically. What ten years ago cost several millions of pounds can now be achieved using a do-it-yourself at home saliva kit for £125.
This science is now becoming affordable and accessible to the majority. One company providing such ‘DNA home collection kits’ is 23andMe. Its CEO Anne Wojcicki is the wife of Google co-founder Sergey Brin, and Google Ventures is one of a number of significant investors in the business.
The kits can be ordered online in the UK and used to: identify whether individuals are at risk of passing on an inherited condition; understand how their genetics might affect their response to certain medications; and explore their genetic traits, such as their body’s ability to metabolise caffeine or their family’s male pattern to baldness. The test will also identify your genetic risk factor for diseases such as Alzheimers and Parkinsons.
Given how much Google already knows so much about our behaviour, if you add information on individual’s genetics this could provide a wealth of information to better manage health and lifestyle choices such as diet and exercise.
Together 23andMe and Google could provide a database of extraordinary value to pharmaceutical firms, medical researchers and insurance companies, while at the same time transforming consumers’ knowledge about their health and medical prospects.
Dr Eric Topol, a pioneering geneticist and cardiologist in the US uses DNA testing and applications to live his life and treat his patients. In a recent interview he stated: “Modern medicine is designed rather for groups and does not account for personal idiosyncrasies, much less medical histories.”
Dr Topol is now seen by many as the world’s leading doctor in wireless medicine and rather prescribes four or five apps to his patients as opposed to medication. Dr Topol uses a modified iPhone (approved by the FDA) to collect a number of readings from his patients such as blood, saliva, urine, sweat tests, as well as a full cardiogram reading.
He believes his patient/doctor relationship is stronger than ever, because he can provide his patients with interactive real-time results to their tests. Patients can perform their tests at home themselves via their mobile device, empowering them with the knowledge to make the right health and lifestyle choices.
What will this level of information do to the UK’s protection industry? If a consumer was to take one of the DNA tests and find out they were susceptible to cancer, a natural human instinct would be to go out and ensure that you and your family are suitably protected by implementing both a life and critical illness policy.
In accordance with the Concordat and Moratorium on Genetics and Insurance agreement between the Government and the Association of British Insurers, clients do not need to disclose the results of a predictive DNA test at this time, but this agreement is due to expire at end of 2017.
Should they have to in the future, this type of cover could become unaffordable/unobtainable to those who need it most.
Conversely, if DNA testing comes back clear, would consumers be less likely to incur a monthly cost for protection against a disease that they have been told is not likely based on their personal genetics?
The impact on underwriting
It is hard to overestimate the impact this will have on the underwriting process. If underwriters are able to access this type of technology or a client’s personal genetic data, an entire redesign of protection products in the future would be inevitable.
If clients were underwritten on the basis of their DNA profiling and rated on their potential for future illnesses, could we see policies adjust in accordance to the way in which a client demonstrates their improved lifestyle choices and real-time health readings in line with their potential future diagnoses?
The difficult question to answer is whether an individual wants to understand their own susceptibilities to diseases such as diabetes or proneness to conditions such as cancer long before they have established themselves in their body.
As an industry we need to start to think about how we will adjust to the impact of this and other related emerging technologies.
Kerry Nicolaides is principle consultant at F&TRC
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