In this first in a series of four webcasts, Peter Banthorpe, Global Head of Research and Data Analytics at RGA, discusses the huge growth in direct-to-consumer (DTC) genetic testing, regulatory policies to control genetic discrimination around the world, and potential for genetic anti-selection in protection insurance.
The first-ever sequencing of the human genome took almost 15 years to complete at a cost of $2.7 billion. Now sequencing costs about $1,000 and can be done in a matter of days. In a few years, it is expected that the whole genome will be sequenced for as little as $100. As DNA sequencing costs continue to plummet and scientific research advances our understanding of genetics, RGA is incredibly optimistic about the potential for genomic medicine to drive morbidity and mortality improvements and increase healthy life expectancy.
The growth of direct-to-consumer (DTC) genetic testing, however, raises concerns about the potential for information asymmetry (where the insurance applicant understands the risk more than the insurer) and anti-selection. In 2017 alone, over 7 million DTC genetic tests were sold compared to 6 million tests sold in all years preceding 2017. Commercial interest in genetics also continues to increase, with many companies developing genetic tests to predict health outcomes and hundreds of apps being developed to generate disease predictions from DTC genetic test data.
The use of genetic information in insurance is a highly emotive subject and elicits a varied set of views across stakeholders; it raises a number of ethical and privacy concerns and we can expect increasing scrutiny from regulators. Notably, in May 2017, Canadian parliament passed Bill S-201 that completely banned genetic discrimination in insurance. As predictive genetic tests improve, and the use of these tests grows in both the medical world and the DTC market, it is highly likely that the information asymmetry will widen if non-disclosure regulation remain in place.
Certainly, we acknowledge and support the need for consumer protection and the right for anyone to have access to the best possible health care without fear of genetic discrimination. In particular, we hope that genomic medicine will soon empower individuals and their families to take preventive measures to reduce risks of future diseases, given a genetic predisposition.
It is worth remembering that life insurance availability depends on an insurer’s ability to assess policyholder mortality and consumer premium rates align to the estimated risk. The growth in DTC genetic testing and the continued scientific advances enabling genetic tests to predict disease onset now give consumers access to risk information that is unavailable to life insurers. In an era of genetic testing, this could signal a significant shift in the information balance between life insurers and consumers.
View additional webcasts in this series:
- Genetics 101: Genetic Risk to Disease and Polygenic Risk Scores (Webcast 2 of 4)
- RGA Research Collaboration with King’s College London (Webcast 3 of 4)
- Genetics and Risks of Anti-selection (Webcast 4 of 4)