Statin Drugs- "Read the Fine Print"

Statin drug therapies have been touted as the most effective treatment for not only slowing the progression of atherosclerotic disease but also key in preventing development of disease by lowering the effects of increased levels of cholesterol. Cardiovascular disease still ranks as the #1 leading cause of death in the U.S. with strokes running a close 3rd-so it makes sense that from the time statin drug therapies were introduced (approximately 2003) there has been a continued rise in prescriptions and even insight into the broader uses of statins as a preventative therapy.

While there has been a focus on all of the positive aspects of statin use, often times the issues surrounding this therapy have been overlooked. There are a number of issues related to statin drug therapy that have prevented many individuals (especially seniors) from utilizing these drugs. Some of the minor issues, that do relate to lack of "tolerance" and use of the therapy long term include; muscle weakness, abdominal cramps, and general athralgias. More severe, and compromising issues include liver function abnormalities, acute renal failure, and heart muscle damage. A news release today indicated an FDA warning against increased uses of one particular statin drug (Simvastatin-sold under the brand name Zocor) at increased levels due to muscle (heart) damage.

There has been a trend by clinicians prescribing this drug therapy to prescribe amounts in excess of acceptable limits (if good is good, than more must be great!) with increased utilization in otherwise healthy individuals. Independent studies have shown that utilizing statin therapy as compared to a placebo show no statistically differences in reducing cardiovascular morbidity and mortality.

For underwriting risk assessment purposes, it does seem reasonable to apply "credits" to those heart patients that have been on long-term statin therapy that have notable stability and control of their lipid levels. It stands to reason that applying mortality improvement across the actuarial curve does not "make sense" given the broad based issues noted with current statin therapies and the lack of long-term mortality/morbidity data related to this therapy.

"A strong positive mental attitude will create more miracles than any wonder drug"

Patricia Neal

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Positive Movement in Life Insurance Activity

MIB-Medical Information Bureau posted their April index which indicates continued gains in individually underwritten life insurance applications. Typically a month that trends down due to normal seasonal fluctuations, this April posted gains for the first time in seven years!

Reflecting a +1.1 gain, older ages (60+) continue to lead the pack with a year-over-year gain of +8.4% but there is surprising increased activity in the middle group (ages 45-59) of +1.0% which has posted positive numbers four months straight.

This information comes on the heels of my travel to a major underwriting industry meeting (AHOU) where underwriting managers and executives seemed positive and upbeat about the increased business they were seeing on their end. Many attributed growth to a renewed marketing and product focus on middle-markets (average death benefits of $1MM) directed at Gen X'rs and continued expansion of simplified products pointed at the baby boomer market.

Trends that require continued monitoring for those active in secondary markets as this will undoubtedly change the future landscape of policy settlements.

"Spring is a true reconstructionist"

Henry Timrod

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