Actuview, the international streaming platform for actuaries, recently held a roundtable with insurance industry insiders to discuss whether longevity is becoming more predictable, how healthcare is shifting from treatment to prevention, what unequal access to new technologies means for health outcomes, and how insurers can turn longevity risk into strategic opportunity. One of the panelists was RGA’s Dr. Adela Osman, Senior Vice President and Head of Global Medical. This article summarizes her insights from the discussion.
Thanks to breakthroughs in many areas of medicine – including cancer research, gene therapy, and precision medicine – we are not just extending life; we are reshaping the curve of serious illness.
Cancer, still a top mortality driver in insured populations, is now being detected earlier through interventions such as liquid biopsy or multi-cancer early detection tests. Gene therapies are rewriting the prognosis on previously untreatable conditions. And individualized medicine allows us to treat diseases and stratify risk with unprecedented accuracy.
But while lifespan is increasing, healthspan and wealthspan are not keeping pace. The average healthspan at birth is about 11 years shorter than lifespan, and wealthspan, which is the ability to fund this extended life, is even shorter. This disconnect presents a critical challenge for insurers as the focus shifts from merely ensuring lifespan to supporting holistic wellbeing and financial resilience throughout life.
Fortunately, science is catching up. Emerging molecular and physiological markers, although still in early developmental stages, have the potential to measure biological age more accurately than chronological age. Studies are also increasingly focused on identifying and testing specific treatments that directly target the biological mechanism of aging.
From my perspective, the rapid advances in medical science and technology are redefining the foundations of biometric modeling. We now have access to real-time health data, predictive analytics, and evolving machine learning capabilities. Insurers increasingly will be able to anticipate and adapt health trajectories. The industry is at the cusp of transformation. We are no longer just insuring how long people live but actively enhancing how well they live and how long they thrive.
Yes, longevity is becoming more calculable, or at least more malleable. More importantly, it is becoming actionable. That opens the door to a new era of insurance innovation for all of us.
Medical innovation and AI have the potential to transform health and life insurance, but their impact in markets with unequal healthcare infrastructure and affordability will be complex and uneven. On one hand, AI-driven tools can improve risk assessment, enable early detection, and personalize care, which could reduce long-term costs and improve outcomes. Insurers could leverage predictive analytics to design more tailored products, potentially making coverage more inclusive for populations that currently face barriers to care.
Even though we are aware of economic disparities and access issues, some immensely successful new treatments are so highly priced that even people at the higher echelon of socioeconomic status may struggle to access them. For example, there is a treatment for spinal muscular atrophy where a single infusion can cost more than $2 million. This creates a paradox: Innovation improves survival and quality of life, but affordability limits its reach.
As with most technologies, prices tend to decline over time as adoption scales and production becomes more efficient. This trend offers hope that advanced treatments will eventually become more affordable and accessible, reducing disparities and expanding coverage options.
Traditionally, we have underwritten a 24-year-old and a 65-year-old in much the same way, using standard forms and asking similar questions. Yet, as individuals age, their risk profile changes significantly, and we now recognize the need to adapt our approach for older applicants. We now understand that factors such as frailty, social connections, cognitive function, and a history of recent falls are essential for accurately assessing risk in older lives, even though they may be less relevant for younger generations. To address this, both product design and underwriting practices have evolved – ensuring we assess risk more precisely and provide the right coverage to the right people at the right time.
There is a question that has been looming for some time: Is aging considered a disease? I think, for now, the answer is no. There are scientists who argue it could be or should be considered a disease process. This would enable us to develop more treatments and extend healthspan. But at present, we consider aging to be a natural, unavoidable process of the human life cycle.
There are multiple interventions, whether through lifestyle changes or the active use of treatments, that can improve longevity. Again, the aim is not just to get people to live longer; rather, it is to get people to live healthier for a longer period of time.
A lot of recent studies look at drugs, such as metformin and rapamycin, to address the aging pathways. Some of these studies show great success. There are mechanisms for improving healthspan and lifespan and managing aging as more of a chronic disease. People should address this with the help of a medical practitioner after a complete, accurate risk assessment. Many people are using over-the-counter supplements hoping that, in isolation, they will improve their aging or longevity. At this point, I do not think that is the correct approach. It needs to be a complementary approach of medical intervention, accurate assessment, and monitoring.
Looking at it purely from a medical perspective, a lot of the investments by private individuals and organizations are about improving longevity, not actively trying to cure a particular disease. But what we do understand about aging is that it is the accumulation of multiple chronic diseases. By addressing the pathways that result in aging, we potentially are addressing the pathways associated with some of these chronic diseases, such as dementia, diabetes, and cardiovascular diseases. There are opportunities from that research to derive earlier interventions to address, manage, or even cure some of these chronic diseases.
We are seeing some improvements – such as kidney function and cardiovascular outcomes in diabetics – from addressing certain metabolic pathways associated with aging. There are many medical scientific groups examining the same pathways and looking for cures for disease, not just improving longevity. Hopefully, there is a combination, and the complementary effect will have a direct impact on disease management, which will then filter down into clinical application and benefit all socioeconomic groups.
Climate change obviously impacts biodiversity, but also the emergence of future pandemics and new infectious diseases. There has also been decreased funding to explore some of these treatment options, and vaccine hesitancy has increased in recent years as well. It is definitely something to keep in mind as it could influence mortality going forward.
We have seen the emergence of diseases we thought were extinct returning in certain areas. This could be directly related to climate change or to changes in environments that are bringing humans closer to the vectors that harbor some of these diseases. This may diminish some of the progress we’ve achieved as a society. It’s essential that we continue investing in research and development to strengthen preparedness for future pandemics or emerging superbugs.
Watch a brief clip of Dr. Osman's comments below. You can see the full roundtable discussion via actuview.
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