Weight-loss medications could reduce mortality rates by up to 20% among users, reshaping how life insurers assess risk and price coverage, Munich Re research shows, though poor adherence rates threaten to complicate underwriting decisions.
The reinsurance giant's study of 41 million insured lives across the United States between 2015 and January 2025 found that users of GLP-1 agonist drugs demonstrated lower all-cause mortality compared to non-users in both diabetic and non-diabetic populations.
The findings align with clinical trial data showing semaglutide – marketed as Ozempic and Wegovy – produced a 20% reduction in major cardiovascular events and a 19% improvement in all-cause mortality, separate research indicated. Real-world studies have shown mortality risk reductions of up to 43% among certain patient groups.
Munich Re forecasted that 0.2% to 0.5% of future annual mortality improvement over the next two decades could stem from obesity drug impacts.
The mortality benefits face a critical obstacle: roughly two-thirds of patients discontinue GLP-1 therapy within the first year, industry studies showed. Among non-diabetic individuals aged 30 to 40, fewer than 30% continued medication use beyond one year, Munich Re data indicated.
Discontinuation rates reached 47.7% at 12 months and 70.1% at 24 months across patient populations, research showed. Patients without diabetes history showed less than 40% one-year adherence, compared to 60% among those with diabetes.
Gastrointestinal side effects topped patient-reported reasons for stopping treatment, with 64.4% citing nausea and 45.4% reporting vomiting, medical studies found. Cost remains a major barrier, with monthly prices ranging from $500 to over $1,000 in the US.
Each 1-percentage-point increase in out-of-pocket costs was associated with higher odds of discontinuation, while younger users aged 18 to 29 were 48% more likely to quit within the first year compared to those aged 45 to 59, separate analyses showed.
The mortality impact could parallel how statins transformed life insurance risk assessment decades ago. Underwriters now view statin use as proactive health management, with insurers often preferring applicants who take cholesterol medications and demonstrate improved health markers, industry practices showed.
Munich Re cautioned that failure to account for GLP-1 usage could create competitive disadvantages, as programs may overestimate risk in individuals experiencing lower mortality from treatments, potentially leading to less competitive offers and adverse selection.
The firm emphasized electronic health records as essential for comprehensive risk assessment, providing longitudinal data including prescription records, laboratory results and follow-up patterns necessary to evaluate treatment adherence and behavioral risk factors.
The findings could also influence critical illness, disability and long-term care product lines through morbidity reduction from lower incidence of cardiovascular events and obesity-related conditions, Munich Re indicated.
