Invest Like the Best with Patrick O'Shaughnessy

Alex Karnal - The Trillion-Dollar Health Revolution - [Invest Like the Best, EP.467]

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Apr 21, 2026
Guest
Alex Karnal
Alex Karnal, co-founder of life sciences firm Braidwell and veteran biotech investor, maps out a coming health revolution. He explores the health stack, why GLP-1s signal proactive healthcare, why PCSK9 drugs may be even bigger, how earlier Alzheimer’s and cancer detection could shift outcomes, and why AI-powered labs could transform drug discovery.
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INSIGHT

PCSK9 Inhibitors Mimic A Natural Genetic Advantage

  • PCSK9 inhibitors may be the closest thing to a free-lunch drug because they mimic a naturally protective genetic mutation.
  • Alex Karnal says blocking PCSK9 can cut LDL about 50%, lower cardiovascular risk around 20 to 25%, and draws confidence from people born with low-PCSK9 mutations.
INSIGHT

Alzheimer's Progress Depends On Treating Earlier

  • Alzheimer's treatment may finally work better if doctors intervene before plaque damage accumulates.
  • Alex Karnal says current anti-amyloid drugs slow decline roughly 30% late in disease, but earlier testing plus earlier treatment could shift from slowing decline to prevention.
INSIGHT

Cancer Is A Detection Problem And An Adaptation Problem

  • Cancer remains hard because we usually find it late and tumors evolve around whatever therapy first works.
  • Alex Karnal is optimistic about pairing early screening like colonoscopy, stool, blood, and multi-cancer tests with newer treatments such as CAR-T and in-body cell engineering.
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