The Rise — And Stall — Of Retail Pharmacy Clinical Trials

By Dan Schell, Chief Editor, Clinical Leader

I’m warning you, what I’m about to say is a rumor.
You know, industry scuttlebutt.
Or as my daughter would say — the tea.

But I don’t think so.

See, more than one person (all of whom are smarter and more “connected” than me) has told me that Walgreens is getting out of the clinical trials game. Wait, I take that back, let me rephrase it … they are reassessing their commitment to pursuing their clinical trials strategy. I swear I’m not using AI for this stuff (maybe I should be!).

No matter how you phrase or spin it, I’m predicting something big is likely happening within the Walgreens Boots Alliance clinical trials business unit. Do I have proof? No. The company has not released any press release about this shift. When I did contact a representative from the company, they replied with the following:

“… please note that Walgreens/Sycamore will not be granting any formal interviews or furnish formal communications on the status of the business at this time.”

In case you don’t know, on August 28, 2025, Walgreens was acquired by Sycamore Partners, a mid-to-large private equity firm that took the retailer private. Fast forward nearly six months, and everything still seemed to be clicking with five Walgreens employees speaking in four different sessions at SCOPE about topics such patient engagement, RWE, and how retail pharmacies can improve access to clinical trials.

So, what changed since then?
I have no idea.

If I had to guess, considering a PE firm is now involved, I’d say it was a financial decision. But honestly, none of that matters, because I don’t think the story is about Walgreens; it’s about the viability of this strategy we saw emerge after COVID of leveraging nationwide pharmacy chains to expand access to clinical trials.

The Advent Of A New Type Of Site

For a brief moment, it looked like the clinical trial industry had finally found its silver bullet. Thousands of storefronts. Built-in patient traffic. Pharmacists who already had trusted relationships with their communities. If recruitment was the industry’s biggest problem, retail pharmacies seemed like an obvious solution.

And to be fair, this wasn’t just hype. Walgreens Boots Alliance, CVS Health, Walmart, and Kroger all made real moves to turn that idea into something operational.

Walgreens launched its clinical trials business in 2022, positioning its retail footprint as a way to improve access, diversity, and real-world data collection. It wasn’t subtle about its ambition; the company talked openly about using its stores as decentralized trial sites and built out a network that, at least publicly, continued to expand through 2024 and into 2025.

CVS moved even earlier. It launched CVS Clinical Trial Services in 2021, with a similar pitch: use retail locations and MinuteClinics to bring trials closer to patients. It was one of the first major players to try to operationalize the concept at scale, and for a while, it looked like they might be setting the pace.

Walmart followed with the launch of the Walmart Healthcare Research Institute in 2022, tying clinical research to its broader push into primary care through Walmart Health. The idea was to combine retail access with clinical infrastructure and reach populations that traditional academic sites often miss. Sounds solid to me.

Kroger, not to be left out, announced its own clinical trial site network in 2023, leveraging pharmacies and The Little Clinic locations to recruit and enroll patients. It even launched a real study, proving this wasn’t just a press release strategy.

For a couple of years, it felt like there was momentum. Not just one company experimenting, but an entire segment of the retail industry converging on the same idea. And for those of us covering this space, it was easy to buy in. We at Clinical Leader wrote about it. A lot, actually. I mean, the logic held up, and the early signals were promising.

Until they weren’t.

CVS was the first to fall. In 2023, just two years after launching the business, it announced it would wind down its clinical trial services unit and exit the space entirely by the end of 2024.

Walmart didn’t exactly exit, but it clearly hit the brakes. In 2024, the company shut down its Walmart Health clinics, effectively removing the clinical infrastructure that had been central to its research ambitions.

Kroger’s trajectory has been quieter. The company’s current messaging suggests it is still working toward broader in-store trial capabilities.

And now, we’re back to Walgreens.

Publicly, Walgreens still presents its clinical trials business as active and growing. Its website remains live. Which makes me wonder: If four of the largest retail pharmacy chains all saw the same opportunity — and then stepped back — what does that say about the model itself?

The Economics Problem No One Talks About

If you talk to enough people in the industry, the reaction to the Walgreens rumor is less shock and more of a shrug. One industry executive I spoke with didn’t hesitate when I asked if they was surprised. They were not. “The unit economics are the challenge, and at some point, you have to figure out how to make the economics ‘work.’” As an example, they pointed to the importance of the CRAACO model, where research is part of the care pathway. When that happens, the economics start to look very different. (Last year, I wrote about a PI who has really embraced this model.)

But that’s not how most retail environments are built.

Let’s face it, many large health systems are struggling financially. AMCs are seeing huge government funding cuts to research, and some are turning to SMOs because they know how to make clinical research profitable.

That got me wondering again about this whole pharmacy-as-a-site model (OMG, did I just invent another acronym, PAAS? Forgive me!) Is the model itself flawed, or were these large players just not the best choices for it? That question led me to Gerald Finken, CEO of RxE2, who has been working on a pharmacy-based clinical trial model since before the major retail chains entered the space.

What About The Pharmacists?

When I asked Finken if the Walgreens news surprised him, he didn’t hesitate. “No, it doesn’t surprise me, but I’m disappointed. I was really rooting for them,” he told me, noting he had been in contact with Walgreens over the past two years and viewed what they were doing as part of a broader, collective effort. “To me, it was a team approach.”

But like others I spoke with, Finken kept coming back to the same issue of economics. Once PE enters the picture, the margin for experimentation shrinks, and the focus shifts quickly to what can be sustained, usually within a short runway.

Still, he doesn’t believe the challenges facing Walgreens — or CVS, Walmart, and Kroger before them — mean the model itself is flawed. Instead, he pointed to a more practical issue: execution at the patient level, and specifically what happens after a patient walks into a store. “The key difference is that the pharmacist knows the patient,” he said, explaining that while large chains may have strong brand relationships, those don’t always translate into the kind of personal connection needed to guide someone into a clinical trial. In many cases, he noted, patients were being handed off to a separate clinical team operating within the same location, creating a break in continuity that made recruitment more difficult. Once that handoff was minimized and patients remained within a consistent care relationship, outcomes (aka recruitment) improved.

Finken’s own model leans more heavily on independent, community-based pharmacies, where those relationships are often stronger and more direct. But even he acknowledged that Walgreens and others weren’t necessarily off track. In fact, he noted that Walgreens had adopted elements of a hub-and-spoke approach similar to what his company is building, with centralized trial sites supported by nearby pharmacies referring patients.

Which brings us back to the bigger question: If multiple players arrived at similar models —and in some cases even similar operational structures — why has it been so difficult to make this work at scale? Spoiler alert … I do not have an answer.

What My Editorial Board Had To Say

Some members of the Clinical Leader editorial advisory board weighed in on this topic for me. I thought Samir Shah framed it well by suggesting that an article “on both the utility and inherent challenges of these setups in large corporate infrastructures” would be worth writing. Craig Lipset agreed, and noted that the trial revenue from CVS and Walgreens would have been a success for a true startup, but it was too small to matter for companies of that size.

Tina Karunaratne had a different (kind of a glass half full) perspective. She felt that we should not look at what companies such as CVS and Walgreens did as failures, but more at what these initiatives taught us about scaling innovation in clinical research. “The truth is that neither company failed at clinical trials. Clinical trials failed to matter to them. Models like CVS and Walgreens didn’t prove pharmacy trials don’t work, rather they proved execution + incentives + integration, and above all, patient input was misaligned. This model can work if the right operating model is in place.”

Karen Correa was also focused on the positive takeaways from this Walgreen rumor (remember, that’s all it is at this point), saying, “What we should learn from this type of news is that it’s imperative we continue to discuss the ongoing challenges within our industry to find innovative ways to recruit patients.” Tina then expanded on that comment by saying that companies like CVS, Walgreens, and Walmart “were supposed to unlock access, improve diversity, and practice decentralized trials. But, we all know that access does not equal participation, and proximity does not equal trust.”

It’s funny, I don’t typically view hearsay or gossip as spurning any type of positive dialogue. But if this rumor does anything, it may be exposing a truth the industry has been slow to admit. Namely, access is the easy part — execution is where these models live or die.