For many (most?) companies starting out, QuickBooks is a natural (and sold) choice for managing the books. Over time, with the growth of the company, QuickBooks will start to show its limitations and a search will begin for a replacement for QB, a new ERP system.
NetSuite has always positioned their solution as a natural “next step” after QuickBooks has reached its end of useful life.
NetSuite is Cost + cost + cost model – the “base” system + Users + Additional NetSuite modules.
NetSuite implementers are most likely to be accounting firms, interested in making their own lives easier (and earning fees from NetSuite). These partners are most interested in “plain-vanilla” implementation, but you are paying for 20 built-in “vertical” solutions.