The significance of diversity in clinical trials is extensively acknowledged, yet regrettably, the presence of diversity remains alarmingly low. Consequently, we face continued challenges with ineffective treatments, suboptimal health outcomes, and a one-size-fits-all approach to medicine that fails to meet the needs of many patients, along with numerous other detrimental effects on healthcare.
The reasons for this lack of diversity in clinical trials are similarly identified, with factors such as language barriers, limited access to healthcare facilities conducting trials, mistrust, and concerns regarding cost and time commitment serving as central issues. While the U.S. Census indicates that 30 to 40 percent of the population consists of minorities, industry research reveals that 80 percent of clinical trial participants are white, with only 45 percent being women.
The problem is multifaceted and requires a comprehensive and long-term solution. However, there are effective measures we can adopt to address the demand for more inclusive clinical trials, ultimately leading to more inclusive treatments.
One such measure is utilizing existing and familiar infrastructure: retail pharmacies.
A significant portion of the U.S. population resides within a five-mile radius of a retail pharmacy.
By employing local pharmacies, such as Walgreens and CVS, as decentralized clinical trial sites, we can enhance the accessibility of clinical trials. Notably, conducting trials within local communities boosts the odds that trial staff and providers reflect the local population, thus reducing potential challenges like language barriers and mistrust.
For instance, one retail pharmacy engaged over 17 million customers to partake in local or hybrid research studies—many of whom had never received an invitation to participate in clinical research before. Among those customers, 63 percent of those invited to engage with the trials are women, with 40 percent identifying as non-white and 53 percent over 60 years old—significantly exceeding historical industry averages.
Pharmacies offer a familiar and trusted setting.
In 2024, a Coresight Research report indicated that more than three out of four Americans purchased items from drugstores or pharmacy retailers. As most Americans frequent a retail pharmacy every quarter, it becomes convenient for clinical trial participants to incorporate trial activities into their regular pharmacy visits with minimal disruption to their daily lives. Given that retention is vital to trial outcomes, we must enhance those that fit seamlessly into participants’ routines—particularly if we aim to enhance inclusivity.
In various communities across the nation, retail pharmacies are crucial and thus represent a notable opportunity to serve as centers for patient education and specialized clinical services.
Pharmacies possess established—and adaptable—infrastructure.
Since many pharmacies already provide services like vaccinations, health screenings, and chronic disease management, they have the facilities and systems that can be tailored for clinical trials. According to Moe Alsumidaie, head of research at CliniBiz, retail pharmacies are uniquely placed to support decentralized clinical trials due to their ability to integrate technology and innovative strategies to make trials more patient-focused and efficient.
Healthcare is intricate, and the path from concept to cure is laden with obstacles. Neglecting or underrepresenting patient populations results in repercussions felt universally, placing patients at risk. Unfortunately, within this framework, women and ethnic minorities carry a disproportionately heavier burden, often experiencing heightened health disparities due to a lack of tailored solutions. Excluding these voices from healthcare innovation not only reinforces healthcare inequalities but also undermines the promise of medical advancements.
Certainly, there is more to be done beyond identifying and expanding locations for decentralized clinical trials. Yet we must start somewhere; and when we do, we must ensure our efforts encompass the entire population that new treatments could potentially benefit.
*Shelli Pavone is a healthcare executive.*