You can argue about the merits of wanting such a UI, but given that the Monodraw developer does, creating a Mac-only app is the only option.
Sure, any cross platform UI can be a trade-off. The question is what is more important, to leave out users of all other platforms by making the UI look more native, or to reach more users.
1. I demoed my application to my friends and they all complained that it didn't behave exactly like a native Mac application.
2. Qt5 has a lot of UI bugs on Mac OS X.
3. The LGPL license of Qt may not compatible with Mac App Store [1].
4. I could buy the commercial license of Qt, but it's $215/month for Mac OS X. I don't know if my app is going to sell at all, so I can't afford that kind of burden.
[1] http://blog.qt.digia.com/blog/2014/10/01/benefits-of-the-ind...
#3 is Apple's fault. I'm not using OS X so I don't know about their installation policies. Do they require to use their store to install applications now? In the past you could just provide packages on your own.