GLP‑1 Weight Drugs Challenge Life Insurance Models

The rapid adoption of glucagon-like peptide‑1 (GLP‑1) therapies for weight loss is creating unprecedented challenges for life and reinsurance companies. Drugs such as semaglutide and tirzepatide, initially developed for type 2 diabetes management, have shown substantial efficacy in reducing overall mortality, but their variable real-world use complicates mortality projections and premium calculations.

A recent study by Munich Re analysed medical and prescription data of 41 million insured individuals in the United States between 2015 and January 2025. The research examined both diabetic and non-diabetic populations and found that GLP‑1 users exhibited a noticeable reduction in all-cause mortality. These findings align with clinical trials of semaglutide, which have demonstrated a lower incidence of major cardiovascular events and deaths among participants.

However, life insurers face several challenges when assessing long-term impacts:

Adherence and persistence: Many patients discontinue therapy or do not adhere consistently, reducing the potential mortality benefit.

Outcome variability: While some individuals experience significant health improvements, others show only modest or transient effects.

Disclosure and behavioural factors: Policy applicants often underreport GLP‑1 usage, complicating accurate risk assessment and underwriting.

Swiss Re’s reinsurance modelling provides an illustrative projection of potential mortality reduction for GLP‑1 users under different adherence scenarios:

Source: Swiss Re Institute – mortality projections through 2045

Incorporating GLP‑1 usage into risk models can help insurers determine accurate premiums and potentially gain competitive advantages. Ignoring the mortality-lowering effect may result in higher-than-necessary premiums, while overestimating the benefit could undermine profitability.

In this evolving landscape, high-quality, longitudinal data from electronic health records and multidimensional modelling are becoming essential. These tools enable insurers to measure the impact of metabolic therapies more precisely, ensuring that population-level health risk accurately reflects the potential influence of GLP‑1 drugs. As the use of these therapies grows, life insurers must balance innovation and caution, adapting their underwriting frameworks to a market transformed by pharmacological advances in obesity management.