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

Author

Listed:
  • 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)

  • Alastair M. Gray

    (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)

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.

Suggested Citation

  • Hermione C. Price & Philip M. Clarke & Alastair M. Gray & Rury R. Holman, 2010. "Life Expectancy in Individuals With Type 2 Diabetes: Implications for Annuities," Medical Decision Making, , vol. 30(3), pages 409-414, May.
    • Handle: RePEc:sae:medema:v:30:y:2010:i:3:p:409-414
    DOI: 10.1177/0272989X09349960
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    References listed on IDEAS

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    1. Chandola, Tarani, 2000. "Social class differences in mortality using the new UK National Statistics Socio-Economic Classification," Social Science & Medicine, Elsevier, vol. 50(5), pages 641-649, March.
    2. Chandola, T., 2000. "Social class differences in mortality using the National Statistics Socio-economic Classification: a reply to Rose and Pevalin," Social Science & Medicine, Elsevier, vol. 51(7), pages 1129-1133, October.
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