Life insurance and reinsurance underwriters are grappling with a potentially transformative shift in mortality risk driven by widespread use of glucagon‑like peptide‑1 (GLP‑1) weight‑loss medications. Recent research by Munich Re indicates that these therapies — including licensed drugs such as semaglutide and tirzepatide — may materially reduce all‑cause mortality among users, but inconsistent use and adherence introduce significant uncertainty for pricing and underwriting models.
The analysed dataset encompassed 41 million insured lives in the United States, with medical and prescription information from 2015 to January 2025. Across both diabetic and non‑diabetic subpopulations, those taking GLP‑1 drugs exhibited a lower relative rate of all‑cause mortality than comparable non‑users during the 2023–2025 study period.
These real‑world observations broadly align with previously published clinical outcomes showing that semaglutide, marketed as Ozempic and Wegovy, significantly reduces major cardiovascular events and mortality. However, the translation of clinical trial results to population‑wide mortality improvements depends heavily on long‑term treatment persistence, which remains low in many settings.
Insurers have long relied on established risk factors — age, smoking status, blood pressure, cholesterol and documented diseases — to assess mortality risk and set premiums. The prospect that GLP‑1 therapy could shift expected mortality outcomes challenges these paradigms, but several unresolved issues complicate integration of such data into underwriting algorithms:
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Adherence and persistence: Real‑world evidence suggests a substantial proportion of patients discontinue GLP‑1 therapy well before achieving sustained weight loss or lasting health benefit, diminishing potential mortality gains.
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Variability in outcomes: Responders to treatment may have markedly different risk profiles compared with those who achieve modest or transient benefit.
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Behavioural and disclosure gaps: Many applicants do not disclose medication use accurately, reducing the quality of underwriting data.
GLP‑1 Mortality Impact Estimates
Reinsurance modelling — such as the projections by Swiss Re — suggests that, under optimistic uptake and sustained use scenarios, GLP‑1 therapies could reduce cumulative all‑cause mortality in the United States by as much as 6.4 % by 2045. Estimates for the United Kingdom under similar assumptions exceed 5 %. However, under more conservative scenarios that factor in poor adherence and limited lifestyle changes, the reductions could fall to around 2.3 % and 1.8 % respectively.
| Projected Cumulative All‑Cause Mortality Reduction by 2045 | United States | United Kingdom |
|---|---|---|
| Optimistic GLP‑1 uptake | ~6.4 % | ~5.1 % |
| Baseline scenario | ~4.0 % | ~3.2 % |
| Pessimistic uptake | ~2.3 % | ~1.8 % |
Source: Swiss Re Institute modelling to 2045.
Industry Implications
For life insurers, incorporating GLP‑1 use into risk assessment frameworks could both improve accuracy and create competitive advantage. Failure to account for mortality improvements may lead to systematic overestimation of risk — potentially resulting in higher premiums than warranted. Conversely, underestimating risk due to overly optimistic assumptions about drug effect and adherence could erode profitability.
This evolving landscape underscores the importance of high‑quality data — including longitudinal electronic health records — and more sophisticated models that account for treatment patterns and behavioural factors if insurers are to adapt effectively to a world in which metabolic therapies influence population health outcomes.