So far this year, just 16 funded U.S. startups in the biotech, drug discovery and medical device spaces have made their debuts on or the , per 附近上门 data. That puts 2025 on track to deliver the lowest number of biotech IPOs in years, as charted below.

The sluggish IPO pace is one of several indicators that investors are growing more risk-averse toward biotech and medtech. Many of the are administration-induced. These include cuts to public research funding, leadership upheaval at the and public health agencies, and questions around future drug pricing policy.

Venture investment in the space hasn鈥檛 fallen off a cliff, but it has dropped considerably. Per 附近上门 data, biotech, pharma and medical device startups pulled in just over $16 billion in seed- through growth-stage financing so far in 2025. That鈥檚 a 25% decline from the same period last year.

Moreover, as charted below, we鈥檙e still nowhere near the peaks scaled a few years ago.

IPOs may be scarcer, but they鈥檙e bigger

Back in IPO-land, meanwhile, the picture isn鈥檛 entirely discouraging. While the number of new market entrants has gone down, their average public market valuation has risen over the past couple of years. Billion-dollar-plus debuts 鈥� once uncommon in the space 鈥� accounted for a quarter of IPOs this year.

So far, 2025 has also brought one unusually large debut, from , an AI-enabled precision medicine company with oncology as a core focus. Irving, Texas-based Caris went public in July and recently had a market cap around $9 billion.

, a developer of hormone therapies for obesity and related conditions, also made a splashy entry in late January. The New York startup, founded just three years ago, was recently valued on Nasdaq at around $3.3 billion.

And most recently, , a heavily venture-funded developer of technology for diagnosing and managing coronary artery diseases, made its Nasdaq debut Tuesday, securing an initial market cap around $2.4 billion.

But although well-received, larger debuts do look bullish for the space, historically small and mid-sized offerings also play a big role in maintaining the health of the biotech startup ecosystem. For companies looking to fund costly R&D and clinical trials in particular, the IPO market has long provided a crucial source of capital.

A case for optimism?

One potential upside of the current investment environment, for some at least, is the potential for deals.

That鈥檚 the outlook from , a partner at focused on early-stage biotech.

He recently : 鈥淭he equity markets have collapsed in 2025, the IPO window is closed, the FDA is in turmoil, the NIH is being gutted 鈥� and it鈥檚 a great time to start new biotech companies.鈥�

Booth鈥檚 reasoning is that because there are fewer startups being created today, there鈥檚 far less competition for resources and talent.

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It鈥檚 one of several startups diving into remote patient monitoring (RPM), a rapidly growing industry that saw favor post-pandemic as the world鈥檚 hospitals were short on beds and clinical practices shuttered their doors.听

Per 附近上门 data, the RPM sector saw a 240% increase in funding between 2020 and 2021. So far in 2022, the area raised more than $220 million in funding, which is larger than any other year besides 2021.听

Not enough labor in health care 听

Remote patient monitoring had long been heralded as a way to help doctors treat patients without seeing them regularly. Using medical devices, physicians could track patient health outside of the clinical setting and intervene early if necessary.听

But for a long time, this class of technology couldn鈥檛 win over doctors and insurers, who were slow to embrace these devices.听

So what鈥檚 fueling the new wave of funding?

鈥淲e’ve hit the wall in terms of human resource shortage. We just don’t have enough humans to take care of other humans on the planet,鈥� said health care consultant , who serves as CEO of , a remote patient monitoring startup with a flagship use-at-home stethoscope.听

鈥淧robably one of the top three problems that hospitals are facing is that they just don’t have enough nurses,鈥� said Smith. 鈥淭hey just don’t have enough people. There just aren’t enough doctors. And so remote monitoring essentially improves efficiency.鈥�

The promise of RPM

The goal of RPM devices was meant to help doctors track their patients between appointments, and develop a better snapshot of how patients fared in their everyday lives outside of the clinic.听

This was especially crucial for patients with chronic conditions with poor disease management, and would allow the doctor to intervene before an upcoming appointment.

鈥淕od forbid something happens in between the first visit and the second visit,鈥� said , principal investor at , who is focused on health care investments.

But early remote patient monitoring devices faced a few key challenges. Comprehensive data tools oversaturated doctors鈥� offices with bits of data collected over the days and weeks of every minute of every patient. This forced clinicians to either sift through a mountain of numbers or ignore it.听

Setting up the technology also proved challenging. Some patients, especially older individuals, ran into troubleshooting issues. This rendered the devices useless and turned workers at doctors鈥� offices into IT help, creating inefficiencies at clinics.听

There was also very little insurance support, which meant a doctor rarely got paid for giving patients an RPM device.

鈥淎 lot of the art of good health care companies is figuring out how to really become part of a doctor’s workflow in a way that really helps them take care of a patient but doesn’t give them a ton of noise,鈥� Effron said.听

Shifting factors

But the tide is turning.听

In 2018, insurance companies created a set of billing codes that allowed doctors to prescribe wearables and bill insurance companies, spurring financial incentive. During the pandemic, to further incentivize using remote patient monitoring technology.听

The technology itself also improved. An increasing number of startups are creating software to pair with medical devices. Leveraging artificial intelligence and machine learning, medical device software can predict changes or irregularities and alert the doctor, as opposed to dumping data on their lap.

How they work

General Prognostics, the two-year-old blood tracking startup, received funding from the likes of , president and CEO of , and .听

The startup provides a wearable sensor for people at risk of heart failure. The sensor, along with the app, collects data on key blood biomarkers like NT-proBNP (which is responsible for cardiac-related functions) throughout the day and alerts the doctor of any abnormalities.听

鈥淭hat’s really important for doctors to know because that tends to happen well before the patient becomes symptomatic,鈥� said , CEO and co-founder of General Prognostics. 鈥淎nd that gives the doctor an opportunity to say, okay, let’s adjust your medications because it looks like you’re destabilized. And if [they] can adjust your meds and get you back stable, we can avoid a hospital visit.鈥�

General Prognostics is currently conducting a clinical study and the company鈥檚 AI is trained on data collected from the participating patients.听

The company says it will meet data requirements from the as well as compete with data competitors in the space have collected. By May 2024, the company expects to get clearance from the FDA and start releasing its device to the public.听

Several of these startups also manage the logistical work of using RPM, unburdening doctors when patients run into issues. For example, , which has an at-home kit that monitors patient vitals, sets up its devices in a patient鈥檚 home. Athelas raised $59 million in January, the largest raise in the RPM space so far according to 附近上门 data.听

Preventative care and power of data

In recent years, there has been a push to collect and leverage data in the health care system to help public health officials, hospital systems and physicians create better predictions about patient health.

This data informs better preventative care, which keeps disease and surgery at bay and proves far cheaper than reactive health care

As a result, it can be argued that RPM startups like General Prognostics play a key role in keeping health care costs low.

For instance, while General Prognostics is currently testing an RPM device to monitor heart failure called CardioID, the same platform could help the startup create software that tracks creatinine鈥揳 strong biomarker for kidney failure.听

Those with general heart diseases may also want to monitor potassium. And everyone from doctors to patients want to monitor these levels in a noninvasive way that doesn鈥檛 involve getting blood drawn regularly.听

鈥�The blood is a very good representative of what’s going on in the body. In the ideal world you should just be able to get that data anytime, anywhere,鈥� said , co-founder and advisor at General Prognostics. 鈥淏ut it’s not the case, we don’t live in that world.鈥�

Problems down the road

With multiple startups popping up, all with gadgets and apps and cloud systems, the RPM industry must brace for consolidation.听

This is especially an issue for what is : Baby Boomers, who will soon become the oldest and longest-living generation in recent history.听

Saddling these users with a handful of disparate devices, all of which perform different functions and require troubleshooting, could defeat the purpose of RPM altogether. Without patient adoption, physicians can鈥檛 utilize any new technology that enters the market.

鈥淓very company that makes a device has delusions of grandeur that the world revolves around their gadgets,鈥� Smith said. 鈥淭he result is just a chaotic mess where nothing really works very well. And getting patients to try and do this stuff is just way too complicated.鈥�

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