GLP-1 drugs: transforming weight loss and Life & Health insurance

The increasing popularity of weight loss injectables like Wegovy and Ozempic come amid an obesity crisis that we are facing globally. By 2035 we expect half of the population to be obese. Obesity rates have crippled since 1975. It's important to tackle this holistically, including looking at lifestyle, policy changes and the food industry. My colleague Adam Strange and I are going to look at the role of GLP-1s and the significance of these new drugs for insurance. Welcome Adam. Thanks, it's great to be here. GLP-1 drugs, weight loss injectables, whatever we call them, there's no denying the amount of media attention they've received. Before we go on to talk about the insurance elements, can we start from the basics John? What are these drugs? What are they doing? What are their long-term impacts? So obesity we know is a risk factor for many conditions, particularly cardiovascular risks, but also things like cancers. Important is that we focus on lifestyle, so telling people how to change what they're eating. The problem, of course, is many people have been told to eat less and exercise more and that doesn't really focus on the macronutrient content or carbohydrates, for example. We also have this problem that we have food ubiquity and very palatable and often addictive foods. So for people struggling with weight loss, these drugs are really useful. The most common, commonly known, are semaglutide, which is brand-named as Wagovi or Ozempic, and then we also have terzapatide as ZepBound for weight loss. The outcomes of these drugs show significant improvement, not just in weight, but in cardiovascular risks and particularly in insulin resistance, which again improves many of the health conditions across the board. Well, there's no denying the impacts of metabolic health in our societies today, and you've listed quite an impressive number of benefits, but we know that every drug has side effects, complications are not going to be right for everybody. What are your thoughts on the long-term considerations we need to have on these drugs? So we don't have very long-term data. These injectables clearly are helping people. There are some short-term side effects. We do worry a little bit about the unknown in terms of the long-term side effects, things like effects on pancreas and thyroid. One of the bigger concerns, I think, is the rebound weight that happens when people stop taking these medications, and we need to find a good way to off-ramp people when they do reduce the medications, and that needs to particularly include lifestyle change. So, Adam, this clearly could have an impact on insurance, and particularly in the life and health space. How do you see this affecting life and health? Well, insurers are going to be paying very close attention to developments here. If these drugs hold the promises that they do, this is going to impact policyholder health. This is going to bring lower morbidity and mortality rates. That's going to improve and impact every major line of business, life insurance, critical illness, disability income cover. For life and critical illness together, cancer and cardiovascular disease are the leading causes of death and claim, and if the drugs are reducing the incidence of these, that's going to have a major impact, and we need to be paying very close attention to that. For disability income or income protection, the message is slightly different. Mental health, but particularly musculoskeletal health, are very closely linked to metabolic health, and improvements to weight loss and reductions in obesity using these injectables, that could have an impact on joint health, which could reduce disability income claims, and if some of these claims are linked to a reduction in employment, for example, claimants may be helped to return to work using these drugs, as well as important lifestyle factors that you've already mentioned. What about cost? These drugs are quite expensive. Yeah, there's no getting away from the fact that these are expensive. They're expensive because they're still on patent, and over the next 10 years or so, depending on the country, they're going to start to come off patent, and generic manufacturers are going to start to come into play. This will reduce costs, and it will also make these drugs far more available. Thank you. It certainly looks like it's going to impact the life and health space considerably. What about underwriting? Yeah, I think there are a few things we need to consider for underwriting, as well. A longitudinal weight history would be very important to look at. Rather than taking a single snapshot in time, let's look at someone's health and weight over many years, perhaps. See the sustainability of weight loss, but also the risk of relapse. Are there any other health impacts that could be noted? I know you and your colleagues are going to be covering this in your 2025 Lifeguide release, keeping underwriters up to date with all the latest information on this heavily changing space. Absolutely, and for more information about this really interesting topic, check out our publication on the boom of GLP-1 drugs.