Effect of statin treatment for familial hypercholesterolaemia on life assurance: results of consecutive surveys in 1990 and 2002
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《英国医生杂志》
1 Oxford Centre for Diabetes, Endocrinology and Metabolism, Churchill Hospital, Oxford OX3 7HJ, 2 Division of Public Health and Primary Health Care, Institute of Health Sciences, University of Oxford, Oxford OX3 7LF, 3 Centre for Cardiovascular Genetics, British Heart Foundation Laboratories, Royal Free and University College London Medical School, London WC1E 6JJ
Correspondence to: H A W Neil andrew.neil@wolfson.ox.ac.uk
Introduction
The increase in mortality rating in the second survey, together with the substantial reduction in the excess applied to patients taking statins show that underwriters now assess risk more realistically and recognise that the prognosis for familial hypercholesterolaemia has improved with more effective treatment.2 Nevertheless variability in the rating applied was considerable, and patients could usefully be advised to shop around for the most competitive premium. The results of the survey, however, are reassuring and should encourage relatives of probands to be tested rather than being deterred by concerns about life assurance.
We thank the life assurance companies for participating in the study.
Contributors: HAWN and DM designed the study, TH conducted the survey, HAWN undertook the analysis, SEH and HAWN wrote the paper. All authors participated in the interpretation and critical revision of the paper. HAWN is the guarantor.
Funding: This work was supported by a grant from the British Heart Foundation (PG2000/015) and was carried out in part with support from the Department of Health and the Department of Trade and Industry for the IDEAS Genetics Knowledge Park.
Competing interests: None declared.
References
Mayor S. UK insurers agree five-year ban on using genetic tests. BMJ 2001;323: 1021.
Scientific Steering Committee on behalf of the Simon Broome Register Group. Mortality in treated heterozygous familial hypercholesterolaemia: implications for clinical management. Atherosclerosis 1999;142: 105-12.
Neil HAW, Hammond T, Huxley R, Matthews DR, Humphries SE. Extent of underdiagnosis of familial hypercholesterolaemia in routine practice: prospective registry study. BMJ 2000;321: 148.
Stone NJ, Levy RI, Fredrickson DS, Verter J. Coronary artery disease in 116 kindred with familial type II hyperlipoproteinaemia. Circulation 1974;49: 476-488.
Neil HAW, Mant D. Cholesterol screening and life assurance. BMJ 1991;302: 891-3.(H A W Neil, honorary cons)
Correspondence to: H A W Neil andrew.neil@wolfson.ox.ac.uk
Introduction
The increase in mortality rating in the second survey, together with the substantial reduction in the excess applied to patients taking statins show that underwriters now assess risk more realistically and recognise that the prognosis for familial hypercholesterolaemia has improved with more effective treatment.2 Nevertheless variability in the rating applied was considerable, and patients could usefully be advised to shop around for the most competitive premium. The results of the survey, however, are reassuring and should encourage relatives of probands to be tested rather than being deterred by concerns about life assurance.
We thank the life assurance companies for participating in the study.
Contributors: HAWN and DM designed the study, TH conducted the survey, HAWN undertook the analysis, SEH and HAWN wrote the paper. All authors participated in the interpretation and critical revision of the paper. HAWN is the guarantor.
Funding: This work was supported by a grant from the British Heart Foundation (PG2000/015) and was carried out in part with support from the Department of Health and the Department of Trade and Industry for the IDEAS Genetics Knowledge Park.
Competing interests: None declared.
References
Mayor S. UK insurers agree five-year ban on using genetic tests. BMJ 2001;323: 1021.
Scientific Steering Committee on behalf of the Simon Broome Register Group. Mortality in treated heterozygous familial hypercholesterolaemia: implications for clinical management. Atherosclerosis 1999;142: 105-12.
Neil HAW, Hammond T, Huxley R, Matthews DR, Humphries SE. Extent of underdiagnosis of familial hypercholesterolaemia in routine practice: prospective registry study. BMJ 2000;321: 148.
Stone NJ, Levy RI, Fredrickson DS, Verter J. Coronary artery disease in 116 kindred with familial type II hyperlipoproteinaemia. Circulation 1974;49: 476-488.
Neil HAW, Mant D. Cholesterol screening and life assurance. BMJ 1991;302: 891-3.(H A W Neil, honorary cons)