Life Expectancy in Individuals With Type 2 Diabetes: Implications for Annuities

Hermione C. Price, Philip M. Clarke, Alastair Gray and Rury R. Holman
Additional contact information
Hermione C. Price: Diabetes Trials Unit, Oxford Centre for Diabetes, Endocrinology and MetabolismUniversity of Oxford, Oxford, UK, Hermione.Price@dtu.ox.ac.uk
Philip M. Clarke: Department of Public Health, Health Economics Research Centre, University of Oxford, Oxford, UK
Rury R. Holman: Diabetes Trials Unit, Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Oxford, UK

Medical Decision Making, 2010, vol. 30, issue 3, 409-414

Abstract: Background. Insurance companies often offer people with diabetes ‘‘enhanced impaired life annuity’’ at preferential rates, in view of their reduced life expectancy. Objective. To assess the appropriateness of ‘‘enhanced impaired life annuity’’ rates for individuals with type 2 diabetes. Patients. There were 4026 subjects with established type 2 diabetes (but not known cardiovascular or other life-threatening diseases) enrolled into the UK Lipids in Diabetes Study. Measurements. Estimated individual life expectancy using the United Kingdom Prospective Diabetes Study (UKPDS) Outcomes Model. Results. Subjects were a mean (SD) age of 60.7 (8.6) years, had a blood pressure of 141/83 (17/10) mm Hg, total cholesterol level of 4.5 (0.75) mmol/L, HDL cholesterol level of 1.2 (0.29) mmol/L, with median (interquartile range [IQR]) known diabetes duration of 6 (3—11) years, and HbA 1c of 8.0% (7.2—9.0). Sixty-five percent were male, 91% white, 4% Afro-Caribbean, 5% Indian-Asian, and 15% current smokers. The UKPDS Outcomes Model median (IQR) estimated age at death was 76.6 (73.8—79.5) years compared with 81.6 (79.4—83.2) years, estimated using the UK Government Actuary’s Department data for a general population of the same age and gender structure. The median (IQR) difference was 4.3 (2.8—6.1) years, a remaining life expectancy reduction of almost one quarter. The highest value annuity identified, which commences payments immediately for a 60-year-old man with insulin-treated type 2 diabetes investing 100,000, did not reflect this difference, offering 7.4K per year compared with 7.0K per year if not diabetic. Conclusions. The UK Government Actuary’s Department data overestimate likely age at death in individuals with type 2 diabetes, and at present, ‘‘enhanced impaired life annuity’’ rates do not provide equity for people with type 2 diabetes. Using a diabetes-specific model to estimate life expectancy could provide valuable information to the annuity industry and permit more equitable annuity rates for those with type 2 diabetes.

Keywords: Diabetes Trials Unit; University of Oxford, UK. (search for similar items in EconPapers)
Date: 2010
References: View references in EconPapers View complete reference list from CitEc
Citations:

Downloads: (external link)
https://journals.sagepub.com/doi/10.1177/0272989X09349960 (text/html)

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:sae:medema:v:30:y:2010:i:3:p:409-414

DOI: 10.1177/0272989X09349960

Access Statistics for this article

More articles in Medical Decision Making
Bibliographic data for series maintained by SAGE Publications ().