Insurance & Nano Medicine

Nano medicine the Big Picture 

Future techniques in medical diagnosis and treatment have often been the subject of science fiction literature and cinema. What was once the stuff of science fiction is now closer to becoming reality. Nature operates at the nanoscale, and today we are acquiring an increasingly profound understanding of natural processes at this scale, enabled by a new generation of scientific instruments. From this knowledge, we are able to design devices that can either directly interact with, or influence, the behavior of living cells. As with any nascent and rapidly developing field, there are research, technological, and ethical challenges to be considered, and the approaches to these constitute an integral part of the vision.

Nanotechnology has a trump card to play when applied to medicine. At the nanometer scale, materials often exhibit surprisingly different physical, chemical and biological properties, compared to the very same material in bulk form. The properties of nanoparticles, such as increased chemical activity and the ability to cross tissue barriers, are leading to new drug targeting and delivery techniques. In the future, a nanoparticle or a set of nanoparticles may be designed to search for, find and destroy a single diseased cell, taking us even closer to realizing the ultimate goal of disease prevention.

Nanotechnology is also making possible the stimulation of the body’s own mechanisms to successfully repair diseased or damaged tissues, replacing the need for transplants and artificial organs. In the foreseeable future, nanotechnology as applied to medicine, will lead to advancement in remote monitoring and care, where a patient may be treated at home - a less expensive option, and one that is more conducive to a successful medical outcome than treatment in a surgery or hospital.

Continued research into disease processes at the molecular level is essential for the development of Nano medicine, and involves teams of scientists from across ‘conventional’ disciplines, such as physics, chemistry, surgery and mathematics, as well as those from the ‘new’ fields of genomics, proteomics, metabolomics, pharmacokinetic modelling and microscope design.

The application of nanotechnology to human healthcare, offers numerous potential pathways  and Millions of Dollars are invested yearly in 84 Nano medicine related research projects that involve around 1000 laboratories.

Let’s have a look at the scope of innovations in Nano-Healthcare- Nano biotechnology and Nano medicine

1. Nanoscale Therapeutic Antibodies with high Target Specificity
2. Specialized  Technology Aids in Targeted Delivery
3. Nanofibers Antimicrobial Effect on Wounds
4. Nanoparticles Delivery of Insoluble Drugs and Peptides
5. Nanoparticle Therapy for Reversal of Macular Degeneration
6. DNA Programmed Chemistry Wide Application Scope
7. Nanoparticles Tunable Delivery Systems
8. Nano spheres Bio friendly Encapsulation and Drug Delivery
9. Protein Biological Surface Immobilization
10. Nanoparticle Therapy against Cancer
11. Nano container Drug Delivery
12. Nano ray Diagnostics
13. Nanomaterials Diagnostics
14. Advanced Nano coatings for Therapy
15. Nanofiber Technology
16. Hydrophobic Silica Nanoparticles
17. Nanocrystals Medical Diagnostics
18. Microfluidic Technology Dispensing Nano Volume of Samples
19. Analysis and Diagnostic Application of Nano printing Technologies
20. Biocompatible and Natural Nano Drug Delivery

 All the above seems promising yet there are a number of uncertainties and risks regarding the production and use of nanomaterials. The real impact of nanoparticles and nanomaterials on human health and the environment is still largely unknown.

Recent research shows that nanoparticles less than 100nm in diameter can enter cells, those with diameters below 40nm can enter the cell nucleus and those that are smaller than 35nm can pass through the blood–brain barrier and enter the brain (Dawson, Salvati and Lynch, 2009). Scientists are calling for a holistic and comprehensive nanotechnology life cycle assessment (LCA) in order to better manage these uncertainties.

Nanotechnology and insurance

Surprisingly the insurance industry  awareness of the Nanotechnology future potential and impact is still at a basic level. A scientific sampling of the insurance industry versus laypeople performed in the US demonstrated in the figure below clearly indicate that only 3.2% of insurers have the necessary knowledge, highly needed to properly assess the risks, Pros and Cons of such emergent technology. 

While preliminary applications indicate health bill reduction in terms of hospitalization time, invasiveness impact, disease targeting, diagnostic procedures… Insurance losses deriving from liabilities can arise at any stage of nanomaterial production and use. Workers can become exposed to nanoparticles and nanomaterials during different stages of the product life cycle such as research and development, raw material production, consumer product manufacturing as well as at the end of the product’s life.

 The employer’s liability insurance policies can be triggered if some nanomaterials happen to be hazardous to the workers’ health and consumers that can come into contact with nanomaterials once the product has reached retailers’ shelves. Professionals such as medical doctors and corporate directors and officers can become subject to some nanotechnology risks (e.g. professional liability can arise from wrong dosages or drug prescription).

In order to assess the perception about the impact of nanotechnology on different sectors, a Mann-Whitney U test was used to look for the differences between three surveyed groups. The test was chosen for three main underlying reasons. Firstly, it is a standard non-parametric test which deals with categorical data that is not normally distributed. Secondly, it is suitable for both small and large samples. Finally, it is used for samples that are independent and possibly of different sizes. Results are shown in the figures below

Figure 2. Insurers, experts and laypeople’s perceptions about the risk posed by nanomaterials to society over the next 15 years in the following areas: workers health, consumer’s health, public health, animal health and environmental pollution.

Figure 3. Insurers, experts and laypeople’s perceptions about the risk posed by nanomaterials to society over the next 15 years in the following areas: medicine, computing, energy applications, cosmetics, clothing, and food sectors

Conclusion and Recommendations

Nanotechnology has been hailed as “the next technological revolution”, which comes with appealing benefits.

Insurers should educate themselves and their perceptions of nanotechnology and nanomaterials should be taken into account in order to assure the sustainable development of the technology.

Insurance does not only compensate for losses, but  can also incentivize nanotech companies to engage in more responsible practices in the production and use of nanomaterials.

Given the fact that the insurance industry is one of the main bearers of the potential nanotechnology and nanomaterials risks, this suggests a need for more information transfer and exchange between the different stakeholders such as Nano scientists, regulators, nanotech companies and insurers themselves.

This in turn could inspire the insurance market to move beyond the “wait and see” approach and encourage the adoption of different strategies to manage potential risks arising from nanomaterials production and use. For example control banding approaches (CB:  technique used to guide the assessment and management of workplace risks) that can be used by underwriters to assess the relative level of nanomaterials production risk. It can also form the basis for an underwriting decision-making process. Better risk communication and collaboration between the insurance market, Nano scientists, regulators as well as nanotech companies could also lead to the introduction of new insurance products. This, in turn, would directly contribute to the sustainability of nanotechnology and nanomaterials development and use.

A vast majority of insurers considered the benefits of nanotechnology to outweigh the risks. However, this optimistic view is in part due to the fact that there have been no reported major adverse events involving nanotechnology and/or nanomaterials to date.

The insurance industry has a tendency to base their underwriting decisions on past experiences (i.e. claims history) rather than hypothetical future scenarios. The perceptions of insurers could shift towards a much more cautious approach in response to new information or due to a loss of a larger scale caused by nanomaterials production and/or use.

This was the case with the terrorism risk which was generally included under open peril property insurance policies. However, after many terrorism attacks worldwide, most insurers excluded terrorism risk from their insurance policies, as it was perceived to be too large and unpredictable, which in turn made the risk temporarily uninsurable.

To avoid a situation where nanotechnology risks become uninsurable, the insurance market has to actively engage in risk communication with other main stakeholders in the field, as well as to adopt a number of precautionary risk management strategies. This is needed in order to manage the impact of possible adverse events that could threaten the ability of the nanotechnology sector to procure insurance, which ultimately could threaten the sustainability of nanotechnology development and use.