Lessons From the First Billion Dollar 1-Person Company

Citrini Strait of Hormuz piece makes waves on X, OpenAI execs taking medical leave amid broader leadership shakeup, Netflix to livestream Artemis II lunar flyby

Apr 06, 2026

Happy Monday.

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The current thing in tech and business is Citrini Research sending analysts to the Strait of Hormuz in a daring mission to assess whether it’s actually open or closed.

Today’s lineup

Better Money Co-Founder Sam Broner at 12:15 PM
Scrub Capital Co-Founder & General Partner Jon Slotkin at 12:30 PM
Semafor Business & Finance Editor Liz Hoffman at 12:45 PM
Sierra Co-Founder Bret Taylor at 1:00 PM
GrayMatter Robotics Co-Founder & CEO Ariyan Kabir at 12:20 PM
Branch Founder & CEO Atif Siddiqi at 1:30 PM

Daily Op-Ed, by John Coogan

Lessons From the First Billion Dollar 1-Person Company

Last week, the New York Times broke down the story of Medvi, a telehealth provider of GLP-1 weight-loss drugs. The framing was basically that this was the first time a single person had built a “billion-dollar company.” At least, that’s what went viral. Digging in, there were some small caveats, like the fact that the founder Matthew Gallagher had hired his younger brother, technically making it a two-person startup.

Another question was valuation. The headline stat in the article was that Medvi is “on track to do $1.8B in sales this year.” That’s insane scale, but companies don’t unilaterally trade at 1x revenue multiples, because margins and revenue durability matter. The article shows that Medvi is a sort of wrapper on top of other wrappers, so the question of margin and long-term value accrual is big.

Medvi uses CareValidate and OpenLoop Health to handle the doctors, pharmacies, shipping and compliance. These GLP-1 drugs aren’t cheap, and when you sell them legally, even as a telehealth wrapper, a lot of value is going to accrue to the pharmaceutical companies that own the intellectual property. At least that’s how it should flow. Add in CAC from running digital ads to acquire customers and you quickly wind up at an estimate of pretty thin margins. Totally possible to get to a valuation lower than a billion dollars depending on how everything flows through the financials. So even without any of the drama that followed, there’s some reasonable questions worth asking about the billion-dollar one-person company claim.

But the drama that followed opened up much bigger questions about how valuable this company really is and how long they will be able to continue their current business without pretty serious changes.

Medvi received an FDA warning letter just two months ago for misbranding violations. “Warning letter” can be a bit wide-ranging, sometimes it requires a small change to marketing materials to remain compliant, sometimes it’s basically a “shut down the company” moment. During my time working on Lucy, we were always extremely careful about warning letters related to the marketing and sale of nicotine products. We can’t make “quit claims” about our nicotine gum for example, so even if we are trying to get active cigarette smokers to buy our nicotine gum, we have to be really careful about what we say. And there is some grey area. JUUL used “switch” instead of “quit” for a long time, but recommending smokers “upgrade” to nicotine gum was always an open question. We wound up playing it safe in all the marketing materials, which probably kept us from mooning revenue to $1.8B overnight, but I still think it was the right decision.

Medvi appears to have taken a much more aggressive approach, running 800+ fake doctor accounts on Facebook to sell compounded GLP-1s. Sheel Mohnot verified that the accounts are not actually doctors (some even have cartoonishly fake names like “Dr. Tucker Carlzyn MD”). The company was also sued in a class-action lawsuit last month for violating California’s anti-spam law.

The end result is more a story of pushing over-aggressive marketing tactics to the limit, than one of AI allowing low-headcount scaling. Back in the early days of online marketing, there were countless stories of questionable supplement sales or telehealth operations scaling on the back of insane ads (the canonical example was “Harvard Scientists” + “Brain Pill” + “Johnny Depp” for some reason).

So what would count as a clean one-person $1b company? I’m personally excited about the prospect of more video game developers seeing breakout success. The poker-themed roguelike deck-building game Balatro has sold over 5 million units, which might be close to $100M in revenue. It was made by solo developer LocalThunk over a two-and-a-half-year period. He originally wanted the game to be a side project he could put on his resume, but it wound up being a massive success. Depending on your valuation methodology, you could probably underwrite Balatro close to a billion dollars, and it was basically entirely developed in the pre-AI era (it came out as a demo in 2023 and officially launched in January of 2024). There is a lot of hesitation in the video game community about the use of AI, particularly in the creation of art assets, but in terms of writing game logic and porting to different gaming consoles, code gen seems like a real accelerant to small developer shops. Balatro broke through because it paired a familiar design language with a wildly engaging progression system. Bringing fun ideas like that to market faster than ever is something I’m certainly looking forward to and it feels like it will yield a much cleaner assessment of AI impact and diffusion.

We will be having Jon Slotkin on the show today to discuss Medvi and the mechanics of telemedicine and GLP-1s. You can read his post on the story here: