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Opioids Probably Kill Insured People, Too

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The recent wave of U.S. deaths related to opioid use is a national tragedy — and it’s also a problem that could be affecting commercial life insurers.

Analysts at Reinsurance Group of America Inc. have come up with data supporting that concern in a new analysis based on data from a prescription drug history database.

Resources:

  • A link to the RGA opioid mortality risk analysis is a slidedeck that includes Alicia Munnell’s presentation is available here.

Federal public health agencies have been reporting high rates of death related to opioid use, and use of other drugs, for years. U.S. life expectancy has decreased for three years in a row, and one of the main causes is the number of accidental deaths related to opioid abuse.

Observers with an interest in commercial life insurance and annuities have wondered, however, whether the spike in opioid-related deaths will have much effect on commercial life insurers. People with life insurance and annuities tend to be healthier and more affluent than members of the general population.

The authors of the RGA opioid mortality analysis say government reports show that overdose death rates have been rising for university-educated people as well as for members of the general population.

The authors say they now have somewhat more direct evidence that opioid use could be affecting the kinds of people who might be expected to have life insurance and annuities.

The authors based their analysis on a database containing data on 3.2 million people, ages 30 to 69, who were eligible for health insurance coverage.

The authors filtered out the people in the database who were taking medications related to deadly health problems, such as cancer. The authors then adjusted the remaining data to account for the likelihood that many of the people still in the data had chronic health problems.

The authors put the prescription opioid users in the filtered, adjusted data into three opioid use categories: short-term opioid users, who had opioid prescriptions for 1 to 30 days over a two-year study period; medium-term users, who had opioid prescriptions for 31 to 120 days during the study period; and long-term users, who had opioid prescriptions for 121 or more days.

  • Short-term users: They had a lower-than-expected death rate, even if they were taking high-strength opiods.
  • Medium-term users: Their all-causes death rate was about average if they took low-strength or medium-strength opioids, and roughly 50% higher if they took high-strength opioids.
  • Long-term users:
    • Low-strength: Their all-cause death rate was about 50% higher than expected.
    • Middle-strength: Their all-cause death rate was about 200% of the expected level.
    • High-strength: Their all-cause death rate was more than 350% of the expected level.

The authors also broke mortality levels down by opioid prescription type.

Both short-term and long-term users of tramadol had an all-cause death rate that was only about 50% higher than the expected level.

Short-term users taking oxycodone had an all-cause death rate that was only a little above the expected level. Long-term users had an all-cause death rate that was about 300% of the expected level.

The RGA analysis itself cannot prove that any people with life insurance have died from health problems related to either prescription or non-prescription abuse. If any opioid use effect on death rates for people with life insurance exists, the effect appears to be small enough that it has not had a clear, material effect on U.S. life insurance underwriting results.

But the analysts at RGA, like analysts at other life and health reinsurers, say the topic is one worth further study.

“While there are certainly limitations with using age and education level as proxies to estimate the experience of the insured population, opioid-related overdose mortality rates are considerably lower for people with higher levels of education,” the study authors write. “However, worsening opioid-related overdose mortality trends among older, educated Americans should be of interest to insurers.”

— Read The U.S. Opioid Epidemic Is a Deadly and Costly Crisis, on ThinkAdvisor.

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