Steve McMichael’s family announces that he had stage 3 CTE

Steve McMichael was diagnosed post-mortem with stage 3 CTE (stage 4 is the highest) after his April 2025 death at age 67. His family and the Concussion & CTE Foundation highlighted a possible link between CTE and ALS; a 2021 study found NFL players are >4x more likely to develop ALS versus the general male population. The article notes Congress-driven rule changes since 2009 aimed to reduce concussions but emphasizes substantial uncertainty about whether modern players face the same CTE/ALS risk and that a reliable living CTE test could materially change player behavior and the sport's future.

Analysis

A validated, in‑vivo CTE diagnostic would be a structural growth lever for diagnostics vendors, CLIA labs and sequencing companies because it converts a historically academic autopsy market into a recurring clinical testing market. Rough math: even a conservative screening program of 500k players/participants per year at $250–$1,000/test implies $125M–$500M annual addressable revenue just from routine monitoring, with an adjacent higher‑margin cohort for confirmatory PET/CSF work. Commercial rollout would be phased (pro teams → colleges → youth/club), giving vendors staged adoption and predictable revenue cliffs over 12–36 months.

The bigger second‑order effect is legal and regulatory: a credible living test compresses plaintiffs’ information asymmetry and can materially accelerate class actions and regulator interventions within 1–5 years, shifting expected liability from probabilistic to measurable claims. That will force sponsors (leagues, schools) and insurers to reserve capital and could catalyze federal/state legislation mandating testing or limiting youth tackle football, altering long‑term participation and media rights trends.

For drug developers, a living biomarker shortens trial timelines and de‑risking for ALS/CTE therapeutics because it provides objective endpoints and enrichment strategies; that raises valuations for ASO and small‑molecule developers if partnered trials show biomarker modulation within 6–24 months. Key downside scenarios that would reverse the market: poor sensitivity/specificity producing clinical ambiguity, privacy/consent laws restricting deployment, or a payor refusal to reimburse, any of which could delay commercialization by multiple years.

Contrarian angle: the market will overprice headline litigation risk for large public franchises while underpricing the commercial diagnostic opportunity. For investors with active capital, early exposure to testing platforms and trial‑enabling therapeutics offers asymmetric upside versus betting on headline settlements alone.

Key Decisions for Investors

• Long Illumina (ILMN) or equivalent sequencing/assay platform — buy a 6–18 month exposure via 12–18 month call spreads sized to 1–2% NAV. Rationale: platform benefit from biomarker discovery and CLIA lab adoption; downside: regulatory delay in clinical assay approval. Target 2:1 upside vs premium paid if adoption accelerates.
• Long antisense/ALS therapeutic developers (e.g., Ionis (IONS) or comparable ASO plays) — establish 12–36 month core position (1–1.5% NAV) to capture trial de‑risking from biomarker‑enabled endpoints. Risk: trial failure; reward: binary re‑rating on positive biomarker‑linked data (3x+ plausible on phase success).
• Seed private/VC stakes in CLIA labs or blood‑based tau/NfL assay startups — allocate $20–50M across 3–5 names with MAE rights. Time horizon 3–7 years; risk high (tech/validation), reward asymmetric (3–10x) if test achieves clinical adoption.
• Hedge litigation risk with selective insurance trades — buy short‑dated protection (equity hedges or CDS where available) on specialty reinsurers or reduce exposure to public leisure brands heavily tied to youth participation. Timeframe: 12–36 months; if mounting biomarker evidence triggers regulation, these hedges should materially outperform.