Multilateralism and the Multinational Enterprise

How do multilateral institutions influence the strategic choices and actions of international managers? This paper addresses the question by exploring the impact of the World Trade Organization's (WTO) decision-making process on multinational enterprises (MNEs). We discuss the three phases of the WTO decision-making lifecycle - the formulation of trade rules, the implementation of those rules, and the enforcement of the rules – and propose a strategic adjustment framework for understanding how companies alter their strategies and structures in response to the WTO's rules and operations. We argue that the increased relevance of multilateral rules and enforcement mechanisms – embodied in the WTO - is an important influence on MNE strategies and structures because of the increasing embeddedness of the WTO in national levels of regulation. We illustrate this through examples taken from the pharmaceutical, textiles and sugar industries sectors that have witnessed substantial multilateral regulation.

A Question of Legitimacy? A Dynamic Perspective on Multinational Firm Control

The control and coordination of a network of geographically and culturally dispersed subsidiaries is one of the most prominent challenges in international management. However, many empirical findings on the effectiveness of various control mechanisms and combinations thereof are still counterintuitive. This study uses longitudinal case studies and cross-sectional interview data to extend control theory by examining why, how, and in what sequence large multinational firms (MNCs) implement controls in their networks of foreign subsidiaries. Our analysis draws from literature on institutional theory, embeddedness, and organizational power to demonstrate that MNC headquarters need to overcome institutional duality when implementing their controls abroad. We find that headquarters do so by using social controls, primarily as a way of legitimizing and institutionalizing their process and output controls that are implemented subsequently.

A multinational, randomised, 12-week, comparative study of donepezil and rivastigmine in patients with mild to moderate Alzheimer's disease

This 12-week, multinational study compared the tolerability and cognitive effects of donepezil (up to 10 mg once daily) and rivastigmine (up to 6 mg twice daily) in 111 patients with mild to moderate Alzheimer's disease. Both medications were administered open label according to recommended dosing regimens from the respective product labelling available during the conduct of the study. More patients in the donepezil group (89.3%) completed the study compared with the rivastigmine group (69.1%; p=0.009), and 10.7% of the donepezil group and 21.8% of the rivastigmine group discontinued due to adverse events (AEs); 87.5% of donepezil-treated patients and 47.3% of rivastigmine-treated patients remained on the maximum approved dose of each drug at the last study visit. Both groups showed comparable improvements on the ADAS-cog administered by raters blind to study medication at weeks 4 and 12. Thus, using the recommended dosing schedules, donepezil was better tolerated with fewer discontinuations due to AEs, and both agents improved cognition to a similar extent.