My general feeling about all the 'Uber-for-X'/food-delivery-startups that launched circa 2015 and mostly fizzled out is that the bottom line was (a) Unit Economics is an unrelenting problem, as Sam Altman describes here and (b) 'Total Addressable Market' is a bit of a vanity number.
(Of course there are other challenges faced by startups that interact with customers in the physical world, like regulation, protectionism and so forth.)
This period was largely enabled by near zero interest rates. Venture capital firms like Thrive Capital in New York specialized in giving start ups with upside down unit economics (see Oscar) capital to subsidize the consumer journey. As this era comes to an end we should see a rise in inflation as an after effect of the suppression of consumer prices by many venture backed services.
On the opposite end of the spectrum are quasi-monopolistic, single product biotech startups. Venture backed companies less than a few years old built around a novel gene therapy "cure". The clinical success of which is triggering a tidal wave of gargantuan merger activity with little sign of cooling down.
Last week Novartis placed a $8.7B bid on AveXis. ($218 per share, an 88% premium). Manufacturer of a miracle MS therapy for young children. A move that could increase the price to over $2.5M per treatment.
When curing a disease with gene therapy is bad business
Amazingly, as outlined in Goldman's note, that lifetime cash flow a pharma developer relies on could be cut short. By "cured" patients no longer requiring long term pharmaceutical therapy!
It makes the space very interesting to watch right now. Particularly as much of the regulation centers upon health or geopolitical concerns. And not on markets or affordability.
My guess is we will see the rise of behemoth-sized global vertically integrated players. Controlling every step of the process. From Research to therapy development. Through patient acquisition. And including the clinical administration of one-shot "cures" in a futuristic branded setting.
Very much resembling something akin to Weyland Industries or Tyrell Corporation. From hollywood sci-fi dreams.