Swiss Re has highlighted significant issues for advisers where drugs originally developed to treat other conditions are being used by clients for potential anti-aging purposes – sometimes without being medically prescribed.
The reinsurer noted this emerging new class of drugs including metformin and rapamycin have gained popularity among health-conscious individuals, with some cases of people self-prescribing these medications.
Given the uncertain long-term effects it has introduced guidance for underwriters on how to assess life insurance applicants who show signs of using these repurposed drugs.
Responding to a query from Health & Protection, the reinsurer identified some key factors to better assess risk such as reasons for the treatment, levels of dosage, how the treatment is administered and complicating factors such as other conditions and side effects of the medication.
“These medications, when used for longevity purposes, present a unique underwriting challenge,” the reinsurer told Health & Protection.
“Many cases require individual consideration, and in some instances, a discussion with a medical officer may be necessary.”
It also provided some ways that advisers and intermediaries could futher understand how their clients may be using such medications.
These include:
- Context and indication for treatment: What is the underlying reason for use?
- Current vs. past use: Is the applicant actively taking the medication or is it part of their medical history?
- Dosage and duration: How long has the treatment been in place, and at what dosage?
- Medical supervision: Was the medication prescribed by a healthcare professional, and is it being used under ongoing medical oversight?
- Adverse effects and complications: Have there been any side effects or complications linked to the medication? For certain drugs like rapamycin, relevant lab results may help determine whether any physiological effects have occurred.
- Comorbidities and concomitant medications: Are there any co-existing conditions or additional drugs being taken that may influence risk?
“These aspects can help form a clearer picture of the individual case, particularly in evaluating whether the current use of a medication is associated with a higher risk,” the reinsurer said.
Uncertain risks
Metformin and rapamycin make up part of a growing list of substances being explored for anti-aging purposes, the reinsurer noted.
Metformin, originally used for managing type 2 diabetes, is being studied for its potential to slow aging by improving insulin sensitivity and reducing inflammation.
Rapamycin, an immunosuppressant developed for organ transplant recipients, has been used in off-label attempts to extend lifespan.
But Swiss Re warned some of these drugs carry an uncertain risk.
Rapamycin, for example, has raised concerns due to immunosuppressive effects and limited long-term data in animals.
In response, Swiss Re has updated its Life Guide to provide underwriters with evidence-based guidance on how to evaluate disclosures of these drugs, including when to apply a rating or defer the case to a medical officer.
The update forms part of its work to adapt underwriting guidance as new insights emerge on life and medical risks and also includes an improved calculator for chronic kidney disease, prostate cancer risks and expanded medical risk assessment tools.
It is used by more than 800 insurance companies across more than 100 countries and supports more than 23 million underwriting queries each year.
GLP-1 inhibitors
And touching on concerns around the increasing popularity of weight loss treatments such as GLP-1 inhibitor drugs Swiss Re pointed to underwriting guidance for GLP-1 medications in March 2025, specifically addressing their use as weight loss treatments.
“While there is emerging evidence suggesting potential longevity benefits of GLP-1 receptor agonists, the data remains limited at this stage,” the reinsurer said.
“Swiss Re continues to actively monitor developments related to GLP-1 medications and the broader use of repurposed drugs in the field of longevity medicine and will update its underwriting guidance accordingly as the evidence base evolves,” it added.