The Pharmacy Benefit No One Is Managing: Clinical Research As A Care Option

By Jon Newton, NewtonBio Consulting Ltd

Most conversations about pharmacy benefits management are conversations about cost: rebates, formulary placement, spread, and specialty spend. That all matters, but it treats pharmacies as the last node in a supply chain rather than a site of care in its own right.

Widen the lens and the conversation changes. Around 9 in 10 people live within a few miles of a pharmacy, and most visit several times a year without an appointment or a referral. Very little else in healthcare has that reach. What else could that proximity do?

One answer is clinical research, and the industry has already tried it on occasion.

COVID-19 gave pharmacies an extraordinary demonstration of their own reach. Having delivered mass immunization at national scale, the major chains concluded, reasonably, that they could deliver clinical trials, too. CVS launched Clinical Trial Services in 2021, Walgreens followed in 2022, Walmart established its Healthcare Research Institute months later, and Kroger announced a trial site network in 2023. Briefly, patient recruitment, the industry's most stubborn problem, appeared to have a new hope.

It did not hold. CVS wound its unit down and exited by the end of 2024. Walmart closed all 51 of its health centers the same year, removing the infrastructure its research ambitions rested on. Kroger went quiet. Walgreens remains the most prominent player and, publicly, an active one: It reports engaging more than 17 million customers in three years and holds a BARDA decentralized trials contract worth up to $100 million. But after Sycamore Partners took it private in 2025, industry press reported in April 2026 that even Walgreens was reassessing its commitment, and the company declined to comment.

It is tempting to read that as proof the model does not work. I would argue it proves something narrower and more useful. Mass immunization is not clinical research. A vaccination is a single protocolized encounter of under 10 minutes; a trial is a regulated, longitudinal obligation involving consent, eligibility adjudication, source documentation, drug accountability, safety reporting, and audit. Standing that up to GCP standards is expensive, and the revenue is execution-dependent: Sponsors pay for patients enrolled and retained, not for potential. What these research units inside large pharmacies produced would have been seen as a strong result if they were small independent startups. However, inside organizations such as CVS and Walmart, measured in tens of billions, it never grew large enough to survive a budget review.  Revenue of a few million dollars is immaterial relative to effort, risk, etc when you are a multi-billion dollar company. 

The subtler failure had nothing to do with footprint. In several of these models, a pharmacist flagged a patient as eligible and then handed them to a separate clinical team working in the same building. The relationship that made the introduction credible ended at that handoff. Access is not participation, and proximity is not trust. Being nearby gets someone through the door; being known is what gets them to enroll and stay enrolled.

This is why the second wave looks different and more durable. Rather than a retailer becoming a research organization, the work is divided. The pharmacy contributes footprint, foot traffic, and an existing patient relationship, while a research-native partner contributes the regulatory machinery.

Walmart's institute now operates through Care Access, which opened its first Clinical Trial Center sites in Texas and Georgia in April 2026, focused on heart and brain health and sited partly in former Walmart Health locations. In the U.K., Civia Health and Boots opened dedicated clinical research units inside four flagship high street stores in January 2026. That marks the first time purpose-built research units have sat inside high street pharmacies. Civia supplies the clinical teams, technology, and operational standards; Boots supplies the location, the visibility, and the relationship. The first study is a Phase 3 program in obesity and type 2 diabetes, and customers can join a health registry and take free screenings.

Boots is also piloting recruitment with Oxford's Primary Care Clinical Trials Unit in Durham, U.K., a response to Pharmacy First shifting patients out of general practitioner surgeries and into pharmacies. And RxE2 has built a hub-and-spoke network across independent U.S. community pharmacies, on the argument that the pharmacist who knows the patient by name is the asset that matters.

All of it points the same way. Most care is delivered in the community, while research remains concentrated in academic centres. That mismatch is why fewer than 5% of eligible patients ever participate, and why rural patients, shift workers, caregivers, and anyone who cannot absorb a day of travel and lost earnings go missing from the evidence base. Moving research closer is not done for convenience alone but also to correct whom the evidence describes.

This is where the benefits conversation should catch up. PBMs and plans already hold what research access requires: eligibility, diagnosis, adherence, and refill data that identify suitable patients earlier and more accurately than any recruitment campaign. If a plan can flag a member for a formulary alternative, it can flag one for a study they qualify for. Treating trial access as a dimension of the benefit would change what a pharmacy visit can offer, particularly to members for whom the standard of care has stopped working.

The retail experiments of recent years are not evidence that pharmacies cannot host research. They are evidence that a pharmacy should not try to become a CRO. The workable version is narrower and more powerful. The pharmacy stays what it already is, the most accessible, most frequently visited point of healthcare in almost every community, and research comes to meet it there.

Clinical research will only become a care option for every patient everywhere when it is offered where patients already are. For many of them, that is a pharmacy.

References:

1. Schell, D. "The Rise — And Stall — Of Retail Pharmacy Clinical Trials." Clinical Leader, 23 April 2026. https://www.clinicalleader.com/doc/the-rise-and-stall-of-retail-pharmacy-clinical-trials-0001 — [Walgreens reassessment reporting; Sycamore take-private; unit-economics and handoff arguments]
2. "Walgreens Launches Clinical Trial Business to Address Industrywide Access and Diversity Challenges." Walgreens press release, 16 June 2022. — [2022 launch date; FDA diversity statistics]
3. "Walgreens Clinical Trials celebrates 3 years, achieving US retail pharmacy milestone." Walgreens Corporate Newsroom, 2025. https://corporate.walgreens.com/newsroom/walgreens-clinical-trials-celebrates-3-years-achieving-us-retail-pharmacy-milestone/ — [17 million customers engaged; participant demographics]
4. "Walgreens and BARDA Form Strategic Partnership to Strengthen Decentralized Clinical Trials Model." Walgreens Boots Alliance, 19 August 2024. https://www.walgreensbootsalliance.com/news-media/press-releases/2024/walgreens-and-barda-form-strategic-partnership-strengthen — [Five-year D-COHRe contract, up to $100 million]
5. "CVS closing down clinical trials business after 2 years." Fierce Healthcare, May 2023. https://www.fiercehealthcare.com/retail/cvs-closing-down-clinical-trials-business-after-2-years — [CVS launch May 2021; phased wind-down; full exit 31 December 2024]
6. "Why Did CVS Shutter its Clinical Trials Unit?" Applied Clinical Trials. https://www.appliedclinicaltrialsonline.com/view/why-did-cvs-shutter-its-clinical-trials-unit- — [Strategic realignment, competition, GCP infrastructure cost analysis]
7. "Walmart Health Is Closing." Walmart Corporate, 30 April 2024. https://corporate.walmart.com/news/2024/04/30/walmart-health-is-closing — [Closure of all 51 health centres]
8. "Expanding Access to Clinical Research: Walmart Healthcare Research Institute and Care Access Open First Locations in Texas and Georgia." Walmart Corporate, 29 April 2026. https://corporate.walmart.com/news/2026/04/29/expanding-access-to-clinical-research-walmart-healthcare-research-institute-and-care-access-open-first-locations-in-texas-and-georgia — [Clinical Trial Center sites; heart and brain health focus]
9. Japsen, B. "Walmart To Launch Clinical Research Sites In Shuttered Health Clinics." Forbes, 22 January 2026. https://www.forbes.com/sites/brucejapsen/2026/01/22/walmart-to-launch-clinical-research-sites-in-shuttered-health-clinics/ — [Siting in former Walmart Health locations]
10. "Civia Health and Boots Partner to Bring Clinical Research to UK High Streets." Boots UK Newsroom, 30 January 2026. https://www.boots-uk.com/newsroom/news-item/civia-health-and-boots-partner-to-bring-clinical-research-to-uk-high-streets/ — [Four flagship stores; first dedicated research units in high street pharmacies; Phase 3 obesity/T2D study; Thrive registry and screenings]
11. "Primary Care Clinical Trials unit partners with Boots to recruit patients where they now seek care." Nuffield Department of Primary Care Health Sciences, University of Oxford, November 2025. https://www.phc.ox.ac.uk/news/boots-pharmacy-duration-trial-recruitment-pilot — [DURATION trial; Durham pilot; Pharmacy First rationale]
12. "Boots partners with University of Oxford to pilot pharmacy recruitment to clinical trials." The Pharmaceutical Journal, November 2025. https://pharmaceutical-journal.com/article/news/boots-partners-with-university-of-oxford-to-pilot-pharmacy-recruitment-to-clinical-trials
13. RxE2. "Community-Based Clinical Trials." https://rxe2.com/community-based-clinical-trials/ — [Hub-and-spoke model; 80/20 problem; independent community pharmacy network]
14. "Kroger Health Establishes Clinical Trial Site Network to Increase Reach and Access to Research Studies." Kroger Investor Relations, 2023. https://ir.kroger.com/news/news-details/2023/Kroger-Health-Establishes-Clinical-Trial-Site-Network-to-Increase-Reach-and-Access-to-Research-Studies/default.aspx
15. "Walmart follows CVS, Walgreens into clinical trial sector." pharmaphorum. https://pharmaphorum.com/news/walmart-follows-cvs-walgreens-into-clinical-trial-sector — [WHRI launch, October 2022]

About The Author:

Jon Newton is founder of NewtonBio Consulting Ltd. in Dublin. He brings more than 25 years in clinical development, including VP-level roles at ICON plc, PRA Health Sciences, and PPD, spanning clinical operations, corporate development, data strategy, and strategic partnerships. He has led global clinical operations and advises a portfolio of digital health ventures. He is chairman of the board for OUTbio Ireland and writes and speaks on trial access, health equity, and the connectivity problems that slow drug development.