A quick update on what I encountered at the recent fall meeting of the Life Insurance Settlement Association (LISA) meeting in the Big Apple this week.
The meeting was held at the Marriott Marquis (highly recommend staying at this hotel-perfect locale in Times Square and overall a really nice facility). The meetings were held Monday and Tuesday, covering a lot of legislation, tax and regulatory issues, pension funds investing in the space, carrier solvency and protection of death benefit, and life expectancy standards. I spoke with one of the organizers on Monday who indicated the turn-out was much better than expected with over 300 attendees.
I primarily focused on the life expectancies and participated in the panel discussion. The discussion was a break-out session and actually quite lively at times with a number of questions from the audience which made this quite enjoyable.The panel rolled out our completion of the Best Practices task force and discussed the major elements established. The Actuarial subcommittee is continuing to evaluate the feasibility of a standardized mortality table.
I enjoyed catching up with a number of my colleagues and LS friends and came away from the meeting feeling that there has been renewed interest in this space and an increase in activity felt by a number of the providers that service these transactions. Which is a welcome relief for most of us in this industry!
Quote of the day: Small opportunities are often the beginning of great enterprises.
Demosthenes (384 BC - 322 BC)
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Friday, November 13, 2009
Mortality Effect of Mid-Life Obesity
Interesting article in Journal Watch. There is increasing evidence that for each unit an individuals BMI increased (over the baseline of >25 kg/m2) the odds for disease-free survival at age 70 decreased by 12%.
The article specifically focused on the following data;
"More than 17,000 women who were healthy at NHS enrollment in 1976 (mean baseline age, 50) and who survived beyond age 70 were included in the study. About 1700 women were still healthy at age 70. After adjustment for confounders, increasing BMI at baseline was associated inversely with odds for healthy survival beyond age 70. For example, women who were obese at baseline had 79% lower odds for healthy survival than did lean women. For every 1 unit of BMI >25, odds for healthy survival decreased by 12%. Also, women who reported gaining weight from age 18 to midlife had less chance for healthy survival than did women whose weight was stable. For every 1 kg of weight gained since age 18, odds for healthy survival were reduced by 5%. Unsurprisingly, healthy survival was lowest among women who were overweight at baseline and who gained 10 kg."
This evidence suggests that obesity is associated with premature deaths. However, the mortality effect on those that actually survive to old age is not clearly understood. Although from an underwriting perspective, we tend to view seniors with a slightly higher BMI as more "robust" individuals and less prone to succumb to acute illnesses.
Underwriting Term Du Jour: BMI- Body Mass Index
Easy Calculation: BMI= (Weight in pounds / [height in inches x height in inches]) x 703
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The article specifically focused on the following data;
"More than 17,000 women who were healthy at NHS enrollment in 1976 (mean baseline age, 50) and who survived beyond age 70 were included in the study. About 1700 women were still healthy at age 70. After adjustment for confounders, increasing BMI at baseline was associated inversely with odds for healthy survival beyond age 70. For example, women who were obese at baseline had 79% lower odds for healthy survival than did lean women. For every 1 unit of BMI >25, odds for healthy survival decreased by 12%. Also, women who reported gaining weight from age 18 to midlife had less chance for healthy survival than did women whose weight was stable. For every 1 kg of weight gained since age 18, odds for healthy survival were reduced by 5%. Unsurprisingly, healthy survival was lowest among women who were overweight at baseline and who gained 10 kg."
This evidence suggests that obesity is associated with premature deaths. However, the mortality effect on those that actually survive to old age is not clearly understood. Although from an underwriting perspective, we tend to view seniors with a slightly higher BMI as more "robust" individuals and less prone to succumb to acute illnesses.
Underwriting Term Du Jour: BMI- Body Mass Index
Easy Calculation: BMI= (Weight in pounds / [height in inches x height in inches]) x 703
Come Visit Me!
www.linkedin.com/in/tddavisaus
www.advanceduwsolutions.com
http://twitter.com/TraciDavisAUS
Tuesday, November 3, 2009
Improvement in Life Expectancy for HIV patients
There has been an outstanding improvement in the life expectancy of HIV patients followed 1996 to 2005-largely related to the development and use of combination antiretroviral therapies. This was a large group study of U.S. patients, over 220,000. positive HIV patients were followed. At the end of 2007, 10,366 patients had died.
The following excerpt regarding study specifics was pulled from "Journal Watch" - www.jwatch.org:
Average life expectancy from the time of diagnosis increased by 12 years during the study period — from 10.5 years in 1996 to 22.5 years in 2005. The greatest annual increase was seen between 1996 and 1997, following the introduction of potent ART, but smaller increases have been seen almost every year since. Throughout the study period, life expectancy was greater for women than for men (23.6 vs. 22.0 years in 2005) and was worst for injection-drug users (15.2 in 2005). Racial/ethnic disparities were evident, particularly among men: In 2005, life expectancy was 25.5 years for whites, 22.6 years for Hispanics, and 19.9 years for blacks. Among women, life expectancy was 21.4 years for whites, 24.2 years for blacks, and 21.2 years for Hispanics.
Underwriting Term du Jour: ART-antiretroviral therapy
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The following excerpt regarding study specifics was pulled from "Journal Watch" - www.jwatch.org:
Average life expectancy from the time of diagnosis increased by 12 years during the study period — from 10.5 years in 1996 to 22.5 years in 2005. The greatest annual increase was seen between 1996 and 1997, following the introduction of potent ART, but smaller increases have been seen almost every year since. Throughout the study period, life expectancy was greater for women than for men (23.6 vs. 22.0 years in 2005) and was worst for injection-drug users (15.2 in 2005). Racial/ethnic disparities were evident, particularly among men: In 2005, life expectancy was 25.5 years for whites, 22.6 years for Hispanics, and 19.9 years for blacks. Among women, life expectancy was 21.4 years for whites, 24.2 years for blacks, and 21.2 years for Hispanics.
Underwriting Term du Jour: ART-antiretroviral therapy
Come visit me at:
www.linkedin.com/in/tddavisaus
www.advanceduwsolutions.com
http://twitter.com/TraciDavisAUS
Monday, November 2, 2009
Screening Prostate and Breast Cancers
Article from Journal Watch,as an underwriter I can vouch for the large numbers of what appear to be "overly aggressive" treatments for these low-grade carcinoma's. Especially when it comes to low-grade prostate cancer in patients over the age of
70. There is a point where the risks certainly outweigh the benefits-even in cancer risks.
Have the benefits been overstated?
Screening for prostate and breast cancers has been promoted heavily in the U.S., and annual screening costs are US$20 billion for just these two cancers. Lifetime diagnoses of prostate cancer were made in 1 of 11 white men in 1980; in 2009, the risk is 1 in 6. For breast cancer, risks were 1 in 12 in 1980 and 1 in 8 in 2009. Authors of a highly publicized review now challenge the value of such intensive screening.
If screening accurately identifies cancer at an early treatable stage, the incidence of localized cancer should increase after screening is implemented, and the incidence of metastatic cancer should decline. Because this pattern has occurred for neither breast nor prostate cancer, screening simply might identify low-risk non–life-threatening cancers that then are treated inappropriately with aggressive therapy. By comparison, screening for colon and cervical cancers has led to significantly fewer cases of advanced disease. The observed decline in prostate cancer–related mortality in the last 20 years probably is not attributable to screening but, rather, to aggressive new adjuvant therapies.
The costs associated with screening are substantial. For breast cancer, avoiding 1 cancer-related death requires annual screening of more than 800 women (age range, 50–70) for 6 years, which generates hundreds of biopsies and overly aggressive treatment for many patients with low-grade cancers.
The authors recommend greater focus on identifying new biomarkers that differentiate low- and high-risk cancers, minimalist approaches that are appropriate for treating patients with low-risk cancers, better tools to guide physicians and patients in informed decision making, and a greater focus on prevention and screening in high-risk patients rather than broad indiscriminate screening.
— Thomas L. Schwenk, MD
Quote for the day: Experience teaches slowly and at the cost of mistakes.
James A. Froude (1818 - 1894)
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www.linkedin.com/in/tddavisaus
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70. There is a point where the risks certainly outweigh the benefits-even in cancer risks.
Have the benefits been overstated?
Screening for prostate and breast cancers has been promoted heavily in the U.S., and annual screening costs are US$20 billion for just these two cancers. Lifetime diagnoses of prostate cancer were made in 1 of 11 white men in 1980; in 2009, the risk is 1 in 6. For breast cancer, risks were 1 in 12 in 1980 and 1 in 8 in 2009. Authors of a highly publicized review now challenge the value of such intensive screening.
If screening accurately identifies cancer at an early treatable stage, the incidence of localized cancer should increase after screening is implemented, and the incidence of metastatic cancer should decline. Because this pattern has occurred for neither breast nor prostate cancer, screening simply might identify low-risk non–life-threatening cancers that then are treated inappropriately with aggressive therapy. By comparison, screening for colon and cervical cancers has led to significantly fewer cases of advanced disease. The observed decline in prostate cancer–related mortality in the last 20 years probably is not attributable to screening but, rather, to aggressive new adjuvant therapies.
The costs associated with screening are substantial. For breast cancer, avoiding 1 cancer-related death requires annual screening of more than 800 women (age range, 50–70) for 6 years, which generates hundreds of biopsies and overly aggressive treatment for many patients with low-grade cancers.
The authors recommend greater focus on identifying new biomarkers that differentiate low- and high-risk cancers, minimalist approaches that are appropriate for treating patients with low-risk cancers, better tools to guide physicians and patients in informed decision making, and a greater focus on prevention and screening in high-risk patients rather than broad indiscriminate screening.
— Thomas L. Schwenk, MD
Quote for the day: Experience teaches slowly and at the cost of mistakes.
James A. Froude (1818 - 1894)
Come Visit Me!
www.linkedin.com/in/tddavisaus
www.advanceduwsolutions.com
http://twitter.com/TraciDavisAUS
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