Can Independent Pharmacies Succeed Where Walgreens Failed?
By Dan Schell, Chief Editor, Clinical Leader
When I was investigating my article about Walgreens stepping back from clinical trials, one name kept coming up in my conversations: Josh Rose. Rose helped shape CVS Health’s thinking around pharmacy-based research years ago, and now he is trying a very different approach through Hawthorne Health — one centered not on national retail chains, but on independent community pharmacies.
I should note that since that Walgreens article ran, another development has surfaced in the retail pharmacy conversation. Walmart recently announced a collaboration with Care Access to support clinical trial activity in stores located in Texas and Georgia. The idea of bringing research closer to patients clearly has not disappeared. What may be changing is how companies think it can actually work.
I’ve never bought into the notion that most of us have these relationships with our pharmacists like in the movies where they greet us by name and know all about us and our families. Still, I think big retail pharmacy chains tried to leverage that fallacy — at least partially — when justifying getting into the clinical trials business. Of course, the financial reality of this strategy eventually caught up to many of them, but Rose insists it a different scenario for the more than 18,000 independent community pharmacies (a stat validated by the October 2025 National Community Pharmacists Association report).
He admits that this independent pharmacy focus is a complicated model but believes Hawthorne has “cracked the code on it.” The company currently operates 11 pharmacy-based research locations and expects to expand that number to 20 by the end of the year. It is running Phase 2 and Phase 3 studies in therapeutic areas including COPD, asthma, dementia, cardiology, dermatology, and metabolic disease. When he told me all of those factoids, my only thought was, “How are they doing this?”
Why Independent Pharmacies Look Different
After my last article, I read a lot of comments from people who were confused on one specific aspect of the concept. Namely, they thought these models failed because the pharmacists are too busy already to add on being a Sub-I or even a coordinator to trial activities. That was never the intent for even the large retailers, but it is definitely not part of the model Rose was touting. “We bring all the clinical research, PI, sub-I, CRCs, etc.,” he explained. “The pharmacy just provides access to patients, the space, and drug management.”
For an independent pharmacy to qualify for Hawthorne’s model, it must meet three requirements: It has to be financially stable, have at least two clinical rooms, and be located in what Rose calls a “clinical research desert” — areas with good healthcare access but few existing trial sites, such as smaller communities outside larger metro areas.
That geography is important because Hawthorne supplies the research infrastructure itself. The company provides the PIs, sub-Is, CRCs, equipment, and clinical trial operations, while the pharmacy contributes patient access, physical space, and drug management. Hawthorne also trains pharmacy staff on research-specific procedures such as GCP and blinding documentation. Rose described the arrangement as highly symbiotic, with each side contributing the pieces needed to build community-based trial sites.
And according to Rose, that familiarity factor can’t be ignored. In fact, it’s one of the model’s biggest advantages. Instead of patients being approached by an unfamiliar research organization, trial awareness comes from a healthcare setting they already trust. “Hawthorne Health is behind the scenes,” Rose said. “Patients usually don’t care who’s running the clinical trial; they just want to feel like it’s in a setting and with people they already trust.”
A Different Kind Of Recruitment Strategy
The operational choreography behind the model is more sophisticated than it may first appear. Rose repeatedly referred to it as “a dance” or “a ballet.” Pharmacy staff are educated on upcoming studies and the types of patients who may qualify. Hawthorne also uses technology to analyze pharmacy databases in a de-identified manner to identify potential patient cohorts. The pharmacy then conducts outreach to patients it already knows through emails, posters, or direct conversations at the counter.
Once a patient expresses interest, Hawthorne’s research staff takes over screening and enrollment activities. The pharmacists keep being pharmacists while the local physicians and clinicians Hawthorne has recruited support each location’s trial needs.
That local presence turned out to be important in sponsor conversations. Rose said pharma companies were uncomfortable with overly remote oversight models, particularly for more complex studies. “For example, you can’t run a dementia study and have a PI in Florida if your location’s in Staten Island,” he explained. With PIs located within driving distance of the pharmacy sites, the studies maintain traditional onsite oversight while still extending research access into underserved communities.
Not Retail Research — Community Research
One of the more interesting parts of the conversation was how strongly Rose pushed back on my comment describing the model as decentralized clinical research. “I don’t view us as DCT at all,” he said. “Take any site network — it’s physical locations, brick and mortar. They have an entrance, they have a waiting room, they have an exam room. That’s exactly what we have. It just happens to be in an independent pharmacy.”
That distinction matters to him because he sees Hawthorne less as a technology-driven decentralization play and more as a community-based site network. The therapeutic areas they pursue reflect that philosophy. Hawthorne avoids highly specialized studies requiring extensive procedures or complex assessments. Oncology and certain CNS studies are not a fit, but chronic diseases (e.g., cardiology, metabolic, respiratory, derm) are. He believes the convenience factor alone can dramatically improve participation for some patient populations.
What Walgreens May Have Missed
Rose never directly criticized Walgreens or CVS during our conversation, but the contrast was obvious. Large retail chains attempted to scale clinical trials through highly standardized retail environments. Hawthorne is instead building around relationships, regional healthcare gaps, and community familiarity. The approach is slower and arguably more operationally complex, but Rose believes it aligns better with how patients actually interact with healthcare outside major urban centers.
“There are many people who are underinsured, partially insured, non-insured, far away from metro areas,” he said. “And the pharmacy, for them, is a form of healthcare.”
That idea may ultimately explain why retail pharmacy research has struggled to find its footing. The opportunity may never have been about turning national pharmacy chains into giant research organizations. Instead, it may be about using trusted healthcare businesses already embedded within communities to extend the reach of clinical trials in a way that feels natural to patients.