Changing the future of cancer mortality
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Changing the future of cancer mortality

Integrating multi-cancer early detection into the life insurance value chain

Cancer is one of the most feared diseases in America.1 Each year, more than 1.7 million new cases are diagnosed and over 600,000 American lives are lost to this deadly disease.2 For decades, doctors have tried to mitigate the impact of cancer through increased research and routine screenings. Yet, cancer still strikes an estimated 40 out of 100 men and 39 out of 100 women during their lifetime.3

While a cure for cancer remains elusive, early cancer detection tools offer hope for patients. By detecting cancer early through the use of single cancer screenings such as colonoscopies, mammograms, pap smears, CT scans, and rectal examinations, the odds of successful treatment improve. However, these guideline-recommended single cancer screenings are limited to five types of cancer: breast, colon, cervical, prostate, and lung.

There are currently more than 100 known types of cancers4, most of which go undiagnosed until it is too late to prevent death. To put this into perspective, 71% of cancer deaths result from cancers with no recommended screening.5

What if people could be screened for more types of cancer with a single test?

Munich Re Life US is partnering with GRAIL, LLC (“GRAIL”) a healthcare company with a mission to detect cancer early, to bring Galleri®, a multi-cancer early detection (MCED) test, to life insurance policyholders in the U.S. 

Through a single blood draw, Galleri® can detect a cancer signal from more than 50 types of cancer—over 45 of which currently lack recommended standard screening—with a low false positive rate. By drastically increasing the number of cancers that can be detected through screening, Galleri® has the potential to transform the future of cancer detection leading to early intervention and higher rates of survival.

100
While over 100 types of cancer have been identified, healthcare providers only commonly screen for 5.
71%
71% of cancer deaths are due to forms of cancer with no recommended screening.
50
Galleri® can detect more than 50 types of cancer with a single blood draw.

Early cancer detection is essential to improving treatment outcomes and survival

The cancer survival rate is 89% when detected early; 21% when diagnosed late.

By partnering with GRAIL, the life insurance industry has an opportunity to improve mortality by bringing early cancer detection testing to a large population of life insurance policyholders. 

According to the Surveillance, Epidemiology, and End Results (SEER) Program Stat Database, when cancer is diagnosed while localized, the survival rate is 89%, compared to a 21% survival rate when diagnosed after cancer has metastasized.6

The need for early cancer detection has never been more urgent, as the COVID-19 pandemic has indisputably impacted the rates of cancer screening. According to the American Cancer Society, in 2020 alone, an estimated 9.4 million people missed cancer screenings in the U.S. 

As a society, we need to take proactive steps to increase cancer screenings and expand the number of cancers that can be diagnosed and treated earlier.

The science of Galleri®

Cancer tumors shed cell-free deoxyribonucleic acids (cfDNA) into the blood which carry signals specific to cancer. Galleri® searches for these signals, and if they are detected, can predict with high accuracy where the cancer is located in the body—for example, in the lung or ovary—even if the individual is not currently experiencing symptoms.

If a cancer signal is detected by Galleri®, patients and physicians can use their Galleri® results to inform the next steps for follow-up diagnosis and initiate treatment as necessary.

In partnership with leading community and academic medical centers worldwide, GRAIL conducted numerous clinical studies with roughly 335,000 participants that demonstrate and support the widespread use of Galleri®. The graph to the below showcases the scale and depth of the Galleri® clinical development program. 

Galleri® clinical development program

Galleri® and potential for early detection

Beating cancer starts with knowing you have it.
Based on modeled data from GRAIL7, individuals between the ages of 50 to 79 who combined Galleri® with their routine care had greater survival rates than those individuals who relied on routine care alone. In fact, the number of deaths that could be averted from adding Galleri® is comparable to the total number of deaths averted over the past 26 years from all combined efforts to battle cancer.8

Already, Galleri® is having a profound effect on people's lives

Meet Keith and Jim.

Keith, a retired engineer, knows early detection is crucial in treating cancers successfully, and when he first learned about Galleri®, instantly felt this test was worthwhile. He took Galleri® and gained peace of mind when he received his results indicating no signals were detected. He hopes Galleri® will become a standard part of healthcare.

Jim, a father and grandfather, had routine checkups and cancer screenings, and he had no reason to believe he had cancer of any kind. Even though Jim felt in good overall health, he took Galleri®, and a cancer signal was detected. Jim was subsequently diagnosed with pancreatic cancer; however, he was diagnosed at a very early stage. Following surgery and chemotherapy, Jim learned his cancer had not spread, and he can now enjoy his life free from worry.

Go to www.galleri.com to view Keith and Jim's videos and hear their full stories in their own words. 

Why life insurance companies should integrate Galleri® into their suite of policyholder benefits

At Munich Re Life US, we believe the life insurance industry can identify a well-defined population that would benefit from revolutionary early cancer detection. Life insurance companies have an obvious incentive to help their policyholders live longer. By adding Galleri® as a post-issue benefit for in-force policyholders, life insurance companies may experience the following benefits.
#1
Cancer is the #1 cause of death for the insured population over age 50.

Mortality reduction on in-force blocks of business

Galleri® can save lives. Bioinformatic scientists at GRAIL, in collaboration with external researchers, developed a cancer stage-shift mode9 to quantify mortality reduction when a patient population over age 50 takes Galleri®. The model establishes that by adding Galleri® to routine care in a patient population over age 50, cancer-related deaths over five years can be reduced by 26%. As cancer is often the number one cause of death among the insured population over age 50, this level of mortality reduction could yield significant financial benefit to life insurers.

Additionally, Munich Re Life US and GRAIL modeled the mortality savings10 from offering Galleri® to a population of life insurance policyholders aged 50-79. We found that mortality savings are heavily correlated with the primary drivers of cancer risk including age, smoking history, BMI, and cancer family history. Mortality savings also varied by insurance product type and policy size. When Galleri® is offered to certain groups of policyholders, the mortality savings can cover the cost of the test, making offering Galleri® a positive return on investment for the insurers.

Sales growth in competitive distribution channels

Adding Galleri® as a benefit in life insurance products is a unique differentiator to boost new business growth. Based on our discussions with insurance distribution companies, there is a high level of excitement in bringing Galleri® to the market. Life insurers who choose to incorporate Galleri® into their products may be well positioned to take advantage of this demand and drive business growth.

Stronger policyholder engagement

In recent years, some life insurers and distributors have started engaging their policyholders by offering customized products based on policyholders’ individual needs. Providing access to Galleri® could be a suitable and highly-desirable benefit for a policyholder with elevated cancer risk, including a policyholder who is older or has a history of smoking, a high body mass index, or a family history of cancer.11

Enhanced brand positioning

Providing access to Galleri® can help reposition the role of life insurance from merely a financial benefit to one that encompasses a policyholder’s wellbeing. By showcasing their commitment to the health and longevity of their policyholders, life insurance companies are likely to be viewed in a  more positive light which may lead to additional product purchases. 

Adding Galleri® to life insurance products

Life insurance companies have an obvious incentive to help their policyholders live longer.

With each passing day, interest in Galleri® is growing substantially within the U.S. Already, Munich Re Life US and GRAIL have established live pilots and are in discussions with top life insurers and distributors to develop programs that seamlessly integrate Galleri® into the life insurance value chain by:

  • Offering Galleri® to existing policyholders
  • Adding Galleri® as a benefit to life insurance products for future new sales

What’s more, the customer experience is at the center stage of this offering. From customer education and test ordering to the blood draw and result delivery process, Munich Re Life US and GRAIL have optimized and streamlined the entire process for life insurance customers. 

Saving more lives from cancer: the time to act is now

While this type of engagement is new for the life insurance industry, we believe policyholders will likely respond favorably to life insurers offering Galleri® and are likely to take advantage of Galleri® and the benefits it provides.

Companies interested in learning more about Galleri® and offering it to their policyholders should reach out to Munich Re Life US directly. Munich Re Life US and GRAIL have created a full suite of easy-to-understand education materials and processes to simplify program integration for you and your teams.

It will take the full weight of the life insurance industry and collaboration across its multiple functions—distribution, insurers, reinsurers, regulators, and GRAIL—to provide greater access to Galleri® for life insurance policyholders. Clearly, the time to act is now if we hope to save dramatically more lives from cancer. As an industry, we have an unprecedented opportunity to transform the fight against cancer. Munich Re Life US hopes you will join us in this critical and important fight.

Contact the authors
Gina Guzman, MD, DBIM, FAAIM, FALU, FLMI
Vice President & Chief Medical Director
Bradley Heltemes
Vice President & Medical Director, R&D, Underwriting Medical
Alex Yang
Alex Yang
AVP & Marking Actuary

Important Safety Information
Galleri® is recommended for use in adults with an elevated risk for cancer, such as those aged 50 or older. Galleri® does not detect all cancers and should be used in addition to routine cancer screening tests recommended by a healthcare provider. Galleri® is intended to detect cancer signals and predict where in the body the cancer signal is located. Results should be interpreted by a healthcare provider in the context of medical history, clinical signs, and symptoms. A test result of ​“Cancer Signal Not Detected” does not rule out cancer. A test result of ​“Cancer Signal Detected” requires confirmatory diagnostic evaluation by medically established procedures (e.g., imaging) to confirm cancer. If cancer is not confirmed with further testing, it could mean that cancer is not present or testing was insufficient to detect cancer, including due to the cancer being located in a different part of the body. False positive (a cancer signal detected when cancer is not present) and false negative (a cancer signal not detected when cancer is present) test results do occur. Galleri® is prescription only.

Laboratory/Test Information 
GRAIL’s clinical laboratory is certified under the Clinical Laboratory Improvement Amendments of 1988 (CLIA) and accredited by the College of American Pathologists (CAP). Galleri® was developed, and its performance characteristics were determined by GRAIL. Galleri® has not been cleared or approved by the U.S. Food and Drug Administration. GRAIL’s clinical laboratory is regulated under CLIA to perform high-complexity testing. Galleri® is intended for clinical purposes.

References

1Centers for Disease Control and Prevention. Leading Causes of Death: Data are for the U.S. https://www.cdc.gov/nchs/fastats/leading-causes-of-death.htm

2Centers for Disease Control and Prevention. Health and Economic Costs of Chronic Diseases. https://www.cdc.gov/chronicdisease/about/costs/index.htm

3American Cancer Society. Cancer Facts & Figures 2022. https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/annual-cancer-facts-and-figures/2022/2022-cancer-facts-and-figures.pdf

4National Cancer Institute. What is Cancer?. https://www.cancer.gov/about-cancer/understanding/what-is-cancer#:~:text=There%20are%20more%20than%20100,tissues%20where%20the%20cancers%20form

5American Cancer Society. Cancer Facts & Figures 2021. https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/annual-cancer-facts-and-figures/2021/cancer-facts-and-figures-2021.pdf

6Based on 5-year cancer-specific survival rates. Source: Surveillance, Epidemiology, and End Results (SEER) Program (www.seer.cancer.gov) SEER*Stat Database: Incidence - SEER 18 Regs Research Data, Nov 2018 Sub. Includes persons aged 50-79 diagnosed 2006-2015. “Early/Localized” includes invasive localized tumors that have not spread beyond organ of origin,“Late/Metastasized” includes invasive cancers that have metastasized beyond the organ of origin to other parts of the body

7Hubbell, E. et al., 2021. Modeled reductions in late-stage cancer with a multi-cancer early detection test. Cancer Epidemiology, Biomarkers & Prevention, 30(3), pp.460–468 

8Siegel R et al. CA Cancer J Clin. 2020;70(1):7-30. Based on data from SEER18 (2006-2017) in the United States, all cancer incidence. Adding Galleri® to usual care (based on modeled data). Assumes long-term screening results with optimized screening interval. MCED, multi-cancer early detection; SEER, Surveillance, Epidemiology, and End Results; US, United States.

9Hubbell, E. et al., 2021. Modeled reductions in late-stage cancer with a multi-cancer early detection test. Cancer Epidemiology, Biomarkers & Prevention, 30(3), pp.460–468

10Mortality saving defined by increase in Total Net Cashflow over 10-year period after taking Galleri®

11Key risk factors for the relative and absolute 5‐year risk of cancer to enhance cancer screening and prevention - Patel - Cancer - Wiley Online Library

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