21st Cen­tury’s Pan­demic/ dis­eases/ viruses

New pan­demic/viruses threats and pre­pared­ness by the in­surer

Insurance - - FOCUS | MEDICAL HEALTH & INSURANCE - by Nitin Dixit Nitin Dixit Is a Se­nior An­a­lyst for Health­care of Frost & Sul­li­van Asia Pa­cific. For more in­for­ma­tion, please con­tact car­rie.low@frost.com

There is an in­creas­ing threat of global pan­demic with the in­creas­ing num­ber of new mu­tant viruses that were never seen be­fore. Af­ter the Span­ish Flu Pan­demic in 1918, that killed more than 50 mil­lion peo­ple, gov­ern­ments across the world are very vig­i­lant about such pan­demics. Other global pan­demics that oc­curred in the last decade are SARS, Avian Flu and Swine Flu. Sev­eral Asian coun­tries have urged for an en­hanced vig­i­lance on H7N9 virus since its re­cent out­break in­fect­ing over 125 peo­ple in China. A new kind of Coro­n­avirus (a strain of virus from the fam­ily that caused SARS in 2003) is ag­gra­vat­ing in the Mid­dle East. Since 2009, more than 2000 cases of H1N1 cases have been re­ported in Malaysia. Al­though the risk of an out­break be­com­ing pan­demic is low, gov­ern­ments/care providers have to be cau­tious about such pro­gres­sion. There has been a de­crease in re­ported cases partly due to in­creas­ing pre­pared­ness and partly due to the greater avail­abil­ity of vac­cines and drugs. Since the out­break of H1N1 in 2009, the Life In­sur­ance As­so­ci­a­tion of Malaysia has an­nounced that all the 16 in­sur­ance com­pa­nies un­der this as­so­ci­a­tion will pay for the claims aris­ing from deaths/hos­pi­tal­i­sa­tion due to H1N1. How­ever, it is im­por­tant to know that not ev­ery coun­try in APAC cov­ers or re­im­burses for im­mu­ni­sa­tion against in­fluenza. In fact In­done­sia and In­dia do not have any national in­fluenza im­mu­ni­sa­tion ini­tia­tives. Be­low is an ex­hibit of coun­tries and their in­fluenza im­mu­ni­sa­tion re­im­burse­ment sta­tus as of 2012. There are very few re­im­burse­ment poli­cies for in­fluenza im­mu­ni­sa­tion in APAC. Pre­ven­ta­tive Vac­ci­na­tion (PV) is not rec­om­mended un­der guide­lines by the re­spec­tive coun­try’s min­istries of health in APAC. Specif­i­cally for peo­ple 50 years of age, it is cur­rently rec­om­mended only for high risk peo­ple and peo­ple who are 65 years of age. PV is seen as one of the im­por­tant meth­ods by ex­perts to con­tain the spread of in­fluenza which can po­ten­tially lead to pan­demic. It is im­por­tant to have wider in­sur­ance cov­er­age for PV against pan­demic dis­eases

Im­pli­ca­tions, for in­sur­ers, with­out cov­er­ing PV: Higher claims due to hos­pi­tal­i­sa­tion/death of pan­demic vic­tims Wider cov­er­age of in­sur­ance cov­er­ing pan­demic dis­eases

Higher claims due to pre­cau­tion­ary health check-ups The cost per per­son in­curred to pay for treat­ment of or death due to such pan­demic dis­eases is a lot higher for in­sur­ers

com­pared to costs in­curred to pay for the vac­cines. Ac­cord­ing to a cost ben­e­fit anal­y­sis study done by Zhao GM, Depart­ment of Epi­demi­ol­ogy in China, in­fluenza H1N1 vac­cine could pro­tect against in­fluenza H1N1 in­fec­tion with a cost-ben­e­fit ra­tio of 2.24:1. That means cov­er­ing a pa­tient for treat­ment of in­fluenza would cost 2.24 times that of vac­ci­nat­ing the per­son. There­fore, there is a need to reach out to stake­hold­ers such as in­sur­ance com­pa­nies and health pol­icy mak­ers in or­der to make PV avail­able for peo­ple in gen­eral in pan­demic prone ar­eas. His­tor­i­cally, it is seen that pan­demics usu­ally start from low lev­els of pub­lic health and they quickly spread to ad­vanced coun­tries. The rapid spread of such dis­eases can be at­trib­uted to in­creas­ing mass air travel (both do­mes­ti­cally and in­ter­na­tion­ally) and the in­abil­ity (by pub­lic of­fi­cials and health­care providers) to con­tain the virus. It is very im­por­tant to get the ‘right’ drugs into the ‘right’ place at the ‘right’ time. The surge in po­ten­tial pan­demic caus­ing viruses has spurred the in­vest­ment in dis­cov­ery and mass man­u­fac­tur­ing of vac­cines and drugs. Tech­niques such as DNA se­quenc­ing and math­e­mat­i­cal mod­el­ling are used to pre­dict the mu­ta­tions of such deadly viruses. While sev­eral ex­perts say that a global pan­demic, es­pe­cially in­fluenza, in the near term is pos­si­ble how­ever it is im­pos­si­ble to pre­dict as to “when” it would oc­cur. There­fore it is im­por­tant for sev­eral stake­hold­ers to be pre­pared in ad­vance of such events. Stricter vig­i­lance by pub­lic of­fi­cials and wider cov­er­age by in­sur­ers are a few steps that might have to be taken.

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