Wearable technology and its impact on the insurance industry

20 Dec 2016

According to a report by wareable.com [1], globally 78 million wearable tech devices were sold in 2015. In 2016 the site estimates sales will be a little over 100 million. The market features start-ups coming to market, such as FitBit and Jawbone, as well as established players such as Samsung and Apple. To give a fuller picture of the health and wellness sensor market, we would need to include the smaller but growing number of medical-grade tracking devices coming out of clinics and being used at home. In order to fully appreciate the scope of health and fitness monitoring, one should also include downloads of apps and virtual platforms to measure health and wellness indicators. One US platform has 60 million subscription paying members.

While proportionately small, a significant minority of individuals are tracking their health and wellness on a daily basis. Why should this interest a re/insurer? First, they can lead to behavioural change. Behavioural change is notoriously difficult to implement, but constant tracking and virtual interaction appears to be finding some traction among certain cohorts. This is being recognised by some re/insurers, who are offering health and fitness reward programmes as part of their life and health product suite. Secondly, tracking devices offer a wealth of data for life and health modellers within the re/insurance industry, which we are just beginning to explore, subject to ethical considerations. Thirdly, and into the longer term, tracking devices will be the first steps to mobile and virtual health delivery, with the potential to deliver better outcomes at lower costs. This is important for re/insurers, as the main payers in most health care systems. Lastly, more into the future, better real time understanding of the health and fitness data at an individual level could shift underwriting practice away from risk pools and historical averages to individual predictive modelling.

Some of this list are already being implemented – others are probably some years away. What is clear is that the market for health and fitness wearables, and the processing of their data, is in its infancy, but is growing rapidly. Swiss Re wants to be an active player in this space. We invited actors from across the wearables value chain – device manufacturers, platform developers, clinicians, and of course re/insurers – to discuss the latest developments and common challenges that face the industry.

References:

[1] http://www.wareable.com/wearable-tech/how-many-apple-watches-sold-2016

Read the related summaries of this event:

A new longitudinal source of health data and facial analytics

Monitoring and diagnosis: Wearable sensors in cardiac care

Engaging consumers in health and wellness: The shift from episodic to everyday

The future athlete

Wearables and advanced analytics in lifestyle change

Internet of medical things: The future of networked biosensors

Leveraging health data to build personal resilience and sustainable high performance

Summary of Francis Blumbergs's presentation at the Centre's Health monitoring event in November 2016. Francis is Head of Strategy & Client Services, Swiss Re. Summary by Simon Woodward.
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Critical Illness (CI) insurance is a living benefits product providing indemnity cover for major medical disorders including cancer. For each disease covered the triggers to pay a sum is defined according to clinical diagnostic criteria. With medical progress prompting evolving clinical guidelines, CI definitions become obsolete. The introduction of liquid biopsy might become a disruptor for the diagnosis of cancer with an urgent need to update the current CI cancer definitions and reconsider reserving for in force CI business.

 

Liquid biopsy is increasingly used in clinical practice and has the potential to alter the diagnostic cascade. This could affect our Critical Illness business. With more cancers diagnosed more claims will be paid. The aim of the Expert Forum on Cancer Diagnostics was to gather insights from experts to understand the potential impact from advances in cancer diagnostics, such as liquid biopsy, on Swiss Re's Critical Illness book of business.

 

The event was split into two; the first part focussed on cancer biomarker technologies and the second part on advances in imaging techniques and the regulatory environment for cancer diagnostics.

 

Kenneth Bloom, from Human Longevity Inc, kicked off the day with an overview of early molecular cancer diagnostics and targeted therapy in cancer care. He highlighted the role of molecular diagnostics in personalized medicine, disease monitoring and surveillance as well as the limitations of liquid biopsy for the early detection of cancer. Nicola Aceto, from the University of Basel, gave a snapshot on liquid biopsy, highlighting success stories and the need for further clinical validation of liquid biopsies before they can be used for the detection of early stage cancers. Vincent Mooser from the University Hospital in Lausanne discussed the use of germline genomics as a cancer risk indicator. Damian Page, from Roche, discussed the current limitations of diagnostics in personalized treatment from a pharmaceutical perspective.  

 

The take home message from the morning session was that the use of liquid biopsies for early detection of cancer is still in its infancy. More clinical validation is needed before liquid biopsy can be routinely used for cancer screening and diagnosis. Liquid biopsies' primary strengths lie in the molecular assessment of minimal residual disease and as a companion diagnostic for targeted therapy. Early warnings about possible recurrence improve disease management and adjuvant therapy, and clues for drug-resistance allow for personal tailoring of therapy. However, the present gold standard for diagnosing cancer remains microscopic and histochemical analysis of a tissue biopsy.

 

Luigi Catanzariti, was the first speaker in the afternoon session. He discussed the use of companion diagnostics and the future of preventive immunotherapy for early stage cancers. He emphasized the fact that diagnostics collaborating is now an integral part of pharma strategy, but regulators treat drugs for targeted therapy and companion diagnostics as two quite different categories. Pierre Hutter, from Sophia Genetics, emphasized the importance of genomic data collection and how the data can be used to learn and improve predictive and treatment algorithms. Hans Hofstraat, from Philips, discussed the role of imaging technologies in detection, staging, monitoring and for follow up of cancer patients. He emphasized applications for personalized therapies and its value for staging cancer precisely. Thomas Hany, from a private radiology practice, closed the afternoon sessions with an overview of the use of imaging technologies in clinical practice, sharing insight with their limitations. 

 

The take home message from the afternoon session was that imaging technologies play a vital role in localizing and staging cancer. This is needed for deciding on best treatment options, and for monitoring recurrences. The speakers highlighted the fact that imaging techniques play an important role for early detection for many cancers, mainly breast and lung cancer. However, even state of the art imaging is limited for early cancer diagnosis. Only when combined with other diagnostic tools such as liquid biopsy diagnostic sensitivity and specificity will be increased.

 

To conclude, modern cancer biomarkers and imaging technologies are extremely useful in the treatment and surveillance of cancer. However, no tumor marker or imaging technology identified to date is sufficiently sensitive or specific to be used on its own for earlier detection of cancer. Tissue biopsy will remain the gold standard for diagnosing cancer in the near future.<[if gte mso 9]> <[if gte mso 10]> <[endif] -->