Organizational Size, Motive, and Adaptation: A Case Study on Pharmaceutical Companies' Reactions to the Introduction of Health Technology Assessment in South Korea

Background Health Technology Assessment (HTA) was proposed to control healthcare expenditure and encourage evidence-based medicine. Since its introduction to the decisions on the price and the reimbursement of pharmaceuticals in 2006, pharmaceutical companies have viewed HTA as a big threat and sought for strategies to buffer the impacts of the new policy on their performances. As little has been known about how pharmaceutical companies in Korea have coped with the environmental change, preliminary studies for enhancing our understanding of this issue were needed. Methods Six multi-national pharmaceutical companies in South Korea were selected for this case study. In-depth interviews with the managers of those organizations were conducted. Interview questions included: (1) any change in organizational structure and managerial activities before and after HTA, (2) primary motives for the change, (3) the perceptions of interdependency, and (4) organizational fit. Participants' responses was recorded and reviewed. Results Findings of this case study showed that pharmaceutical companies employed different strategies to reduce uncertainties resulted from HTA. Two key factors contributing the variations were found: organizational size and primary motive for organizational change. Larger companies, for example, were able to recruit health-economics experts or create new teams earlier and more actively than smaller ones. Further, the motives for these changes could be categorized as functional, economical, and social ones. The functional motive was obvious among early adopters, while social motive was more important to the followers. Conclusion Consistent with previous researches, the results of this study also highlighted the significance of organizational size and motive as key variables to explain different responses to the same change in environments. In spite the findings of this preliminary study are meaningful, further empirical researches to address the full mechanism how the organizational contingencies interact with psychological factors and identify other variables more than size or motive are highly suggested.