Walmart's Clinical Trial Model Faces Its Real Test

By Dan Schell, Chief Editor, Clinical Leader

I’ve spent a fair amount of time this year writing about the challenges of bringing clinical trials into retail pharmacies. In April, I examined the rise and stall of retail pharmacy clinical trials, including the experiences of Walgreens, CVS, Walmart, and Kroger. A month later, I explored whether independent pharmacies might succeed where the large chains struggled.

Despite those setbacks, I’ve never thought the concept was inherently flawed. Retailers have convenient locations, established relationships with their communities, and access to people who may never have considered participating in clinical research. But there’s a big difference between having access to potential participants and successfully recruiting them into clinical trials.

That’s why the latest announcement from Walmart and Care Access caught my attention. The two organizations have opened four clinical trial centers inside Walmart stores and plan to open three more in 2027. Better yet, the initial centers aren’t simply offering health screenings and information about clinical research. They’re conducting trials, enrolling participants, and administering investigational medicines.

That’s encouraging, but it also raises a question I think deserves more attention: Is this evidence that retail-based clinical research is finally finding a workable model, or simply evidence that an experienced research organization can operate clinical trial sites inside a Walmart? Those are two very different things.

Four Centers Open, Three More Planned

On October 27, the Walmart Healthcare Research Institute (WHRI) and Care Access celebrated the opening of their first clinical trial centers with an event in Houston, TX. The initial four locations are in Houston and Tyler, TX; Dalton, GA; and Brandon, FL. The organizations also announced plans to open three additional centers during the first half of 2027 in Livonia, MI; Las Vegas; and San Antonio, TX. That would bring the network to seven locations across five states.

The partnership, first announced in January, is intended to make clinical research more accessible by locating research facilities inside stores that people already visit. The centers support Phase 2, 3, and 4 studies, including research involving cardiovascular disease, Alzheimer’s disease, and GLP-1 therapies.

Eli Lilly was identified in the announcement as a sponsor with studies enrolling through the centers. That’s an indication of actual sponsor involvement, although the release didn’t identify specific protocols or provide enrollment figures.

I wanted to understand more about what was happening inside these locations, particularly how the clinical operations were structured and whether Walmart’s retail environment was providing any measurable advantages. I requested an interview with Care Access. Instead, I received written responses to my emailed questions from Rupi Bancil, SVP, global study operations & global expansion at Care Access. Her answers helped clarify how the centers operate, although they also left some important questions unanswered.

Walmart Is the Venue, Not the Operator

The first thing worth understanding is that these facilities are located inside Walmart buildings but operate as independent, fully equipped clinical research sites. All trial procedures take place within these dedicated research spaces, not Walmart’s shopping areas. According to Bancil, the centers can perform laboratory sample collection and processing, infusions, FibroScan examinations, walk tests, and other procedures typically conducted at established research sites, including academic medical centers.

Care Access also supplies the clinical research personnel. Bancil said the company recruits experienced professionals from local communities while drawing on its national workforce and global clinical operations network. “This approach allows us to begin providing health screenings and conducting clinical trials as new centers open, while building dedicated local teams to support ongoing operations,” she wrote.

Each location has one or more dedicated PIs from Care Access who oversee the studies conducted there. Bancil said those investigators undergo the same sponsor qualification and approval processes used at traditional research sites.

All of this info is important to understand, because the No. 1 criticism I’ve heard repeatedly about using pharmacies as clinical trial sites is that pharmacists already have enough responsibilities. Expecting them to take on clinical research operations, particularly complex protocols, is unrealistic. That’s not what we’re talking about in this situation. It’s similar to the independent pharmacy model I previously discussed with Josh Rose of Hawthorne Health, where a research organization assumes responsibility for trial operations rather than expecting pharmacy employees to become research coordinators.

But here’s where I think we need to be careful about celebrating this arrangement as an operational breakthrough (my words, not theirs). Care Access already operates more than 200 research sites worldwide and has experience staffing sites, managing investigators, and conducting trials. Establishing four functioning research facilities is certainly an accomplishment, but is Walmart an integral part of a new research delivery model, or primarily a provider of convenient real estate and potential participant traffic? The answer could have important implications for whether this arrangement can scale, and at this point, I don’t think any of us knows the answer.

There’s also the financial question. Neither the announcement nor Bancil’s responses establish how costs and revenues are divided between the organizations, or whether the arrangement will be economically sustainable. Separating retail and research responsibilities may solve some operational problems. It doesn’t automatically solve the business challenges that have affected previous retail research initiatives.

Conversations Aren’t Enrollments

Perhaps the biggest assumption behind retail-based clinical research is that putting trial opportunities in places people already visit will translate into greater participation. It’s a reasonable hypothesis, but it remains that — a hypothesis.

Bancil said the centers have entrances accessible from within Walmart stores, supported by signage, posters, and informational tables. She added, “Our on-site clinical research teams are having hundreds of one-on-one conversations with Walmart shoppers about their health and opportunities to participate in clinical research.”

That’s great, and I commend Walmart and Care Access for taking these steps. At the very least, all of this can help raise awareness about what clinical trials are. But conversations aren’t enrollments. And someone interested in a free health screening isn’t necessarily interested in participating in a clinical trial that may involve investigational treatment, multiple visits, or a lengthy commitment.

Bancil confirmed that participants had already been screened, enrolled, randomized, and administered IP, but the company declined to provide specific enrollment or retention figures, which I get, especially at this early stage.  I also wondered about how many participants are coming directly from Walmart foot traffic versus other recruitment channels, which I think is important. In other words, if most participants are recruited through conventional methods, the fact that their study visits occur inside a Walmart doesn’t necessarily mean that the retailer’s customer traffic is improving recruitment. If the goal is to expand access and improve representation, the organizations will eventually need to demonstrate that they’re doing more than shifting participants from one research setting to another.

A Different Model, But Is It A Better One?

I know what you’re thinking … we’ve seen this model tried to varying degrees over the years. But this Walmart/Care Access partnership does appear to draw a clearer line between the retailer’s responsibilities and those of the research organization. It basically clarifies that experienced research organizations can use retail locations as community access points. Does that mean it’s a “shift,” or an “evolution,” or even what everyone likes to say about any little change they implement these days — an innovation?

Frankly, who cares how it’s defined. I don’t.

The fact is: These new sites exist, and there will be more opening soon. Great. But no matter how they are set up with their staffing and operational expertise, they are still going to experience the tried-and-true challenges of sponsor demand, recruitment costs, protocol complexity, participant retention, and the economics of maintaining research facilities.

It’s too early in this partnership to be making any predictions on its success. Let’s give it some time and see if these centers can recruit and retain participants effectively, reach people historically underrepresented in research, and provide access to individuals who otherwise might never participate. I mean, no one is questioning whether Care Access can conduct clinical trials inside Walmart. They do that at sites all over the country. What will be interesting to find out is whether conducting those trials at Walmart makes those trials … better. And I’ll leave it up to you to define that word.