The importance of diversity in clinical trials is well-documented, yet unfortunately the lack of diversity still occurs at an alarming rate. As a result, we continue to have less effective treatments, poorer health outcomes, one-size-fits-all medicine that falls short of many patients, and many more negative impacts on health care.
The reason for lack of diversity in clinical trials is similarly known, with language barriers, limited access to health care facilities conducting the trials, mistrust, and concerns about cost and time commitment being among some of the central causes. While the U.S. Census shows that 30 to 40 percent of the population are minorities, industry research shows that 80 percent of clinical trial participants are white and only 45 percent are women.
While the problem is complex and requires an equally comprehensive and long-term solution, there are impactful steps we can take to address the need for more inclusive clinical trials that will ultimately lead to more inclusive treatments.
One of those includes leveraging existing and familiar infrastructure: retail pharmacies.
A large majority of the U.S. population lives within a five-mile distance of a retail pharmacy.
By using local pharmacies, such as Walgreens and CVS, as decentralized clinical trial sites, we can make clinical trials more accessible than ever before. Importantly, hosting trials in local communities increases the likelihood that the trial staff and providers are representative of the local population, eliminating potential issues like language barriers and mistrust.
For example, one retail pharmacy invited more than 17 million customers to participate in local or hybrid research studies—most of whom had never been invited to participate in clinical research before. Out of those customers, 63 percent invited to engage with the trials are women, and of that population, 40 percent identify as non-white and 53 percent are over 60 years old—well above historic industry averages.
Pharmacies provide a familiar, trusted environment.
In 2024, a Coresight Research report found that more than three out of four Americans bought products from drugstores or pharmacy retailers. Because the majority of Americans visit a retail pharmacy every quarter, it is convenient for clinical trial participants to integrate trial activities into their routine pharmacy visits with little to no disruption to daily life. With retention being critical to trial outcomes, we need to increase those that fit seamlessly into participants’ lives—especially if we want to improve inclusivity.
In communities around the country, retail pharmacies play an important role and, as a result, represent a significant opportunity to be used as hubs for patient education and specialized clinical offerings.
Pharmacies have established—and adaptable—infrastructure.
Since most pharmacies already offer services like vaccinations, health screenings, and chronic disease management, they have the facilities and processes that can be adapted for clinical trials. According to Moe Alsumidaie, head of research at CliniBiz, retail pharmacies are uniquely positioned to support decentralized clinical trials due to their ability to incorporate technology and innovative approaches to make trials more patient-centric and efficient.
Health care is complex, and the journey from concept to cure is fraught with challenges. When we overlook or underrepresent patient populations, the repercussions are felt across the board, putting patients at risk. Unfortunately, within this spectrum, women and ethnic minorities bear a disproportionately heavier burden, often facing amplified health disparities due to the absence of tailored solutions. A failure to include these voices in health care innovation not only perpetuates health care inequalities but casts a shadow on the potential of medical advancements.
There is work to do, of course, beyond identifying and scaling locations for decentralized clinical trials. But we need to start somewhere; and, when we do, we must ensure the efforts are inclusive of the entire population that new treatments have the potential to help.
Shelli Pavone is a health care executive.
