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  • October 2024

Insights from Japan on Comprehensive Cancer Coverage

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In Brief

As medical advances promise to revolutionize cancer detection and treatment, Japan’s experience with comprehensive cancer coverage may offer insights into the opportunities and challenges in other markets.

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Key takeaways

  • Japan’s experience with comprehensive cancer coverage may offer insights into potential opportunities and challenges in other markets.
  • Liquid biopsies and improving survivorship are two emerging trends changing the cancer coverage landscape.
  • Cancer products launched in other Asian nations augment Japan’s example to illustrate other possible coverage options. 

 

Japan has long been at the forefront of cancer care. This focus has translated into a thriving cancer insurance market where carriers offer a range of specialized products to provide financial protection from the costly burden of this disease.

One key feature of Japan's offerings is an emphasis on simple yet comprehensive coverage. Most products offer lifetime coverage. The three most popular products are:

  1. Diagnosis products, which issue a lump-sum payment when cancer is diagnosed.
  2. Treatment products, which issue a monthly payment during treatment for surgery, chemotherapy, and other related expenses.
  3. Non-private health insurance (non-PHI) products, which allow for medical expense reimbursement for advanced cancer treatment not covered under Japan’s public health system.

Japanese consumers have embraced the peace of mind and financial security these products provide. That said, the Japanese market may offer valuable insights for other markets into the challenges of developing cancer-focused insurance products. With medical advances revolutionizing cancer detection and treatment, insurers worldwide would be well-served to seek out examples of successful cancer coverage. 

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Emerging trends: liquid biopsy and improving survivorship

As technology evolves, life insurers should closely monitor two trends poised to shape the future of cancer insurance:

  1. The rise of liquid biopsy
  2. Improving survivorship

Liquid biopsy: a potential game-changer in cancer detection

While a traditional biopsy requires extracting tissue samples, a liquid biopsy offers a less invasive approach by analyzing bodily fluids such as blood, urine, or cerebrospinal fluid. The key innovation is its ability to detect and analyze fragments of DNA/RNA shed by cancer cells into the bloodstream or other bodily fluids. 

By identifying these fragments before symptoms appear, a liquid biopsy can theoretically detect cancer at a more treatable stage. Earlier interventions could dramatically transform patient outcomes. 

Healthcare providers may also gain a deeper understanding of a patient's cancer, including the presence of any remaining disease post-treatment and a potential resistance to certain therapies. They can then tailor a treatment plan and monitor a patient's progress without the need for repeated – and potentially risky – invasive biopsies. 

This approach holds the potential to revolutionize screening, diagnosis, and disease tracking. It is important to note, however, that a recent study has challenged the efficacy of a widely used liquid biopsy blood test, and further research will be necessary. 

For insurers, the widespread adoption of liquid biopsy technology could significantly impact cancer coverages. Currently, diagnostic capability for early-stage cancer is limited, and the high frequency of false positives increases medical costs due to excessive testing. Over time, this could result in higher claims volume, limiting product sustainability. 

Liquid biopsy for precancerous lesions is currently undergoing clinical trials and may transform the diagnostic process. If fluid tests alone could one day predict the risk of developing cancer from precancerous lesions and enable early-stage treatment, it would lower healthcare costs and reduce the burden on patients. Also, the definition of cancer could expand to include lesions that have a high probability of becoming cancerous. 

Increasing the number of diagnosed cases is only one factor. Earlier-stage cancer tends to have a better prognosis, leading to a larger pool of survivors. Because most cancer products in Japan provide lifetime coverage with unlimited payment, this has a significant impact on product sustainability. 

The improving survivorship of cancer 

With genetic and molecular information obtained from liquid biopsies, oncologists can select the most appropriate targeted therapies or immunotherapies for each patient's unique cancer profile. This precision-medicine approach could lead to more effective, tailored treatment plans and further improve survivorship. 

By altering the traditional risk profile and claims patterns associated with cancer, this shift has profound implications for the insurance industry. Increased availability of advanced cancer drugs will accelerate this evolution. Private insurance policyholders who have the financial means to access advanced treatments and drugs – even those outside the public health system – will be especially affected. 

In the past, cancer insurance policies in Japan often provided lump-sum payouts either at diagnosis or during the initial course of treatment. With more survivors, insurers must adapt their products and underwriting strategies to address policyholders’ evolving needs. This may include extended coverage periods, more comprehensive benefits for ongoing care, and innovative risk-management strategies. 

Insights from across Asia 

As insurers observe the unique challenges of the Japanese market, they can also draw lessons from nearby nations. By examining features and trends of cancer and critical illness insurance products in various markets, insurers can gain a broader understanding of the global landscape and identify opportunities for cross-pollination of best practices. 

In Asian markets outside Japan, cancer is usually part of critical illness insurance, providing lump-sum payments for a range of serious conditions. Products typically include a maximum number of times to file a cancer claim, limiting the exposure to future cancer risk. For example: 

  • A Hong Kong multiple-pay cancer product pays 500% of the sum assured, after which the policy terminates. Expanding coverage beyond cancer while applying limits mitigates risk through diversification.  
  • In Korea, a move to lower payments for early-stage thyroid cancer seeks to manage a growing trend of over-diagnosis.  
  • Similarly in China, regulators recommend lower payments for certain cancers linked to over-diagnosis and anti-selection. 

Applying the lessons from Asia 

As both the insurance market and cancer risks continue to evolve, the industry must remain responsive to emerging trends. Liquid biopsy and the increased number of cancer survivors present both challenges and opportunities for insurers, requiring new products and strategies to meet the changing needs of policyholders.

By drawing insights from global markets, particularly from Japan and other Asian countries, forward-looking insurers and reinsurers can expand and transform the cancer and critical illness insurance landscape. In doing so, they can help ensure that individuals and families have access to comprehensive financial protection when they need it most. 


 

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Meet the Authors & Experts

Manson Choi
Author
Manson Choi
Regional Research and Development Actuary
Hong Kong