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  • In the lead-up to Bowel Cancer Awareness Week (6 - 13 June), the study by researchers from the Royal Melbourne Hospital and BioGrid Australia, is the first to combine Australian screening data with treatment costs and survival rates, providing new evidence of the program's economic and social benefits
  • Slide 1

    1. 1. Medical advances and their effect on insurance products and claims experience<br />Dr Bill Monday<br />Chief Medical Officer<br />Comminsure<br />
    2. 2. Insurance Medicine is interesting...no really it is!<br />
    3. 3. Agenda<br />Discussion around Australia’s Health in 2010, innovation and implications for insurance medicine including:<br /><ul><li>Life expectancy
    4. 4. Good news with cancer
    5. 5. Genetics
    6. 6. Good news with Cardiac disease
    7. 7. Imaging techniques, e-medicine
    8. 8. Not so good news on Obesity
    9. 9. Diabetes -the new epidemic
    10. 10. Concluding remarks</li></li></ul><li>Advice from the past!...<br />
    11. 11. Analysis of the report from AIHW 2010<br />
    12. 12. Expected Life Expectancy in Australia –something to be proud of.<br />
    13. 13. Life expectancy compared to the rest of the world ( 2005-2010)<br />
    14. 14. Iceland- Friday night fun<br />
    15. 15. Cancer<br />
    16. 16. The main cancers<br />
    17. 17. Breast Cancer<br />Worldwide, it is the most common form of cancer in females, affecting, at some time in their lives, approximately one out of nine to thirteen women who reach age ninety in the Western world. <br />A Woman’s Chances of Breast Cancer Increases With Age:<br />At age 30 1 in 2212<br />At age 40 1 in 235<br />At age 50 1 in 54<br />At age 60 1 in 23<br />At age 70 1 in 14<br />At age 80 1 in 10<br />
    18. 18. Breast Cancer Treatments<br /><ul><li>Surgery
    19. 19. Chemotherapy
    20. 20. RadiationTherapy
    21. 21. Hormone Therapy
    22. 22. TargetedTherapy</li></li></ul><li>Cancer- Smart bombs and nanotechnology<br />New chemotherapy drugs deliver drugs only to specific cells inside the human body without affecting surrounding tissue. <br /> Drugs are also targeting the blood vessels that are needed to supply nutrition to the cancer ( Avastatin)<br /> Genetics will help individualise therapy<br />
    23. 23. Improvements in 5 year cancer survival over 20 yrs<br />
    24. 24. Cancer Distribution by Stage (3 of the top 5 cancers)<br />Ref: Bowel cancer treatment costs quadruple in 10 years. Cancer Council Victoria, June 2010. <br />
    25. 25. Bowel Cancer Treatment Costs<br />
    26. 26. The ‘Hidden’ Costs<br />In 2005, The Cancer Council of NSW commissioned an independent report on the cost to an individual and their family, following diagnosis of cancer:<br /><ul><li>Report highlighted out-of-pocket costs related to reduction in income, transportation, medications, specialist clothing and mobility devices, childcare and housekeeping costs, carer costs to name but a few...
    27. 27. Back in 2005, the quoted out-of-pocket cost to an individual after diagnosis of cancer ranged from $10,000 to $203,600, with an average amount of $47,200!</li></ul>Ref: The Cancer Council of NSW, 2005.<br />
    28. 28. Cancer<br />Cancer being detected at an earlier stage thanks to screening<br />Genetic testing playing a role in predicting risk and steering surveillance<br />Prognosis and cure rate improving<br />Underwriting an increasing amount of people with a history of cancer. Better<br />survival helping to offer better ratings<br />Post cancer monitoring for reoccurrence improving<br />Lifestyle modification, screening, vaccines, genetic testing , targeted therapy, and<br />stem cell therapy exciting and optimistic<br />
    29. 29. Genetics<br /><ul><li>There are >3000 molecular (genetic) diagnostic tests on the market
    30. 30. Genomics and personalized medicine will exponentially increase the speed of change of evidence </li></li></ul><li>Cardiac Disease<br />
    31. 31. Heart Attack<br />The rate of heart attack continues to fall and survival continues to improve<br />There has been a magnificent fall of over 70% in death rates from the late 60’s<br />
    32. 32. Interventional Cardiology<br />
    33. 33. Cardiac Disease- Scanning<br />
    34. 34. Coronary Artery Scoring<br />Low-risk = Green, Intermediate-risk = Yellow and High-risk = Red<br />
    35. 35. Imaging and scanning<br />
    36. 36.
    37. 37. Life was much simpler when Apple and Blackberry were just fruits<br />
    38. 38. Preventative cardiology<br />In Australia in 2007 there were 70 million prescriptions for drugs to prevent<br />or treat cardiovascular disease in 3.8 million Australians <br />(18% of the population)<br />Drugs for lowering cholesterol have increased by 27% over the last years<br />
    39. 39. Obesity and the metabolic syndrome<br />
    40. 40. BMI Classification of WHO<br />Source: WHO 2000 / 2004<br />
    41. 41. Trend in prevalence of overweight and obesity<br />Percent of pop.<br />
    42. 42. Relative Risk of Death From All Causes by BMI<br />Source: Calle EE, Thun MJ, Petrelli JM, Rodriguez C, Heath CW Jr: Body-Mass Index and Mortality in a Prospective Cohort of US Adults. NEJM 1999; 341:1097-1105<br />
    43. 43. Lapband Surgery<br />
    44. 44. Relative risk of Diabetes Diabetes Care, January 2007<br />BMI < 25, active = 1<br />BMI < 25, inactive = 2,08<br />BMI > 30, active = 10,74<br />BMI > 30, inactive = 16,75<br />
    45. 45. Diabetes in Australia<br />800 000 Australians have diabetes- This is 3 times as many as 20 years ago<br />85-90 % of these diabetic are Type 2 diabetics<br />
    46. 46. Future treatment options for diabetics- looking bright<br /><ul><li>Future is looking bright
    47. 47. External insulin pumps/ports available
    48. 48. Easier insulin delivery – inhaled insulin/pills
    49. 49. New insulins - simpler regimens
    50. 50. Transplantation
    51. 51. Glucose sensing Radio Frequency Identification (RFID) microchip. The microchip, once implanted under the skin, allows users to scan it to receive wireless glucose data. This device is currently awaiting FDA approval.
    52. 52. Gene therapy
    53. 53. Neogenesis/vaccines against type 1 diabetes</li></li></ul><li>Dialysis<br />Protein in urine<br />Hypertension<br />HBA1C<br />Below 6 Excellent<br />Below 8 Good<br />Above 8 Concerning<br />Above 10 Very concerning<br />Above 12 Awful<br />Cholesterol<br />Other cardiac risk ie smoking<br />
    54. 54. Inserting human gnes into flower!<br />Scientists at the University of Calgary inserted a human insulin gene into safflowers.  The seeds of the plant can be ground, with very inexpensive insulin refined from the resulting oil.  It would take just 16,000 acres (25 square miles) of these salflowers to meet the insulin demand for the entire world<br />
    55. 55. Accumulation of risk<br />10 year risk of a cardiovascular event or death based on Framingham data<br />
    56. 56. Smoking is decreasing<br />COPD Deaths/ 100 000 population<br />
    57. 57. Mental Health and disease burden<br />1 in 4 Australians aged 16-24 have experienced a mental health disorder during the preceding 12 months<br />Disability Adjusted Life Years lost per 1000 population<br />
    58. 58. Mental Health in Australia<br />
    59. 59. Injuries – The Human Factor<br />
    60. 60. Conclusion<br /><ul><li>Australia can be proud of it’s health- we rank very high globally
    61. 61. Very promising trends in cancer and cardiology
    62. 62. Lifestyle risk and obesity concerning
    63. 63. Diabetes is becoming an epidemic
    64. 64. Genetics will play an ever increasing role
    65. 65. Better imaging techniques will assist with diagnosis and treatment
    66. 66. Tele-medicine and robotics taking off</li></li></ul><li>Conclusion<br /><ul><li>Medical technology and information is assisting in providing accurate risk assessment and prediction
    67. 67. Education and training is paramount to stay abreast as medical information is doubling every 18 months
    68. 68. Underwriting is becoming an ever increasing speciality
    69. 69. Improving survival with better disease management and surveillance is translating into better ratings and insuring a cohort of applicants that were previously uninsurable</li></li></ul><li>Thank you<br />Questions?<br />

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