The impact of multifactorial genetic disorders on critical illness insurance: A simulation study based on UK biobank

Angus Macdonald, Delme Pritchard, Pradip Tapadar

Research output: Contribution to journalArticle

Abstract

The UK Biobank project is a proposed large-scale investigation of the combined effects of genotype and environmental exposures on the risk of common diseases. It is intended to recruit 500,000 subjects aged 40-69, to obtain medical histories and blood samples at outset, and to follow them up for at least 10 years. This will have a major impact on our knowledge of multifactorial genetic disorders, rather than the rare but severe single-gene disorders that have been studied to date. What use may insurance companies make of this knowledge, particularly if genetic tests can identify persons at different risk? We describe here a simulation study of the UK Biobank project. We specify a simple hypothetical model of genetic and environmental influences on the risk of heart attack. A single simulation of UK Biobank consists of 500,000 life histories over 10 years; we suppose that case-control studies are carried out to estimate age-specific odds ratios, and that an actuary uses these odds ratios to parameterise a model of critical illness insurance. From a large number of such simulations we obtain sampling distributions of premium rates in different strata defined by genotype and environmental exposure. We conclude that the ability of such a study reliably to discriminate between different underwriting classes is limited, and depends on large numbers of cases being analyse. © 2006 by Astin Bulletin. All rights reserved.

Original languageEnglish
Pages (from-to)311-346
Number of pages36
JournalASTIN Bulletin: The Journal of the IAA
Volume36
Issue number2
DOIs
Publication statusPublished - Nov 2006

Keywords

  • Case-control study
  • Critical illness insurance
  • Gene-environment interaction
  • Odds ratio
  • Premium rating
  • Simulation
  • UK biobank

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