Abstract A growing number of announcements on new and innovative medical devices are reported each year by economic actors. However, very few new technologies are successfully acquired and adopted by healthcare actors. To examine how economic and healthcare system actors perceive entrepreneurs’ strategies employed to respond to and address healthcare system actors’ pressures following firm’s emergence, we gathered data with 20 healthcare system and economic actors using semi-structured interviews and thematic analysis. We have determined that the acquisition and diffusion of health technologies are increasingly regulated and must respond to increasing pressures from many actors who see their agency power decline. We have found that political strategies address the pressures from institutionalization of practices and decoupling of the health system and its goals, associative strategies react to the power of key influencers such as investors and medical specialists, and mistrust of marketing actions, normative strategies respond to pressures stemming from the growing need for evidence-based data; finally, identity strategies answer to the fragmentation of a public health system and the heterogeneity of local procurement processes are approached. The results may help medical professionals, decision-makers, and evaluators to understand medical device acquisition and diffusion process better.