LOS ANGELES – For the past two years, Walgreens has tried to leverage its nationwide footprint to recruit customers who pick up drugs at its stores into clinical trials, in an effort to diversify participation in studies of new medicines.
Other retailers have struggled with similar efforts to expand beyond their core pharmacy operations. Last year, CVS ended its clinical trial endeavors after two years, and earlier this year, Walmart closed several of its medical clinics. Walgreens hasn’t escaped such troubles either, announcing earlier this year it was closing 160 of its Village MD clinics due to slow growth.
Despite this, Walgreens is “doubling down” on its efforts in clinical trials, said Ramita Tandon, the company’s chief clinical trials officer. She previously worked as the chief operating officer of Trio Health, a clinical data solution provider, and the executive vice president of commercialization and health outcomes at the clinical research organization, ICON.
Last month during a panel on health equity and economics at the Milken Institute Global Conference in Beverly Hills, she spoke with STAT’s Nicholas St. Fleur about how the retailer is attempting to address the lack of diversity in clinical trials. Here are edited excerpts from the panel discussion and a subsequent interview with Tandon about reaching underserved populations, creating partnerships for clinical trials, and utilizing AI to find potential patients to recruit.
What is Walgreens doing in the clinical trial space?
We’ve got over 8,700 stores and pharmacies across the U.S. We serve roughly around 130 million lives that visit our stores and pharmacies. During the Covid pandemic, when everything was shut down, the federal government had reached out to the retail pharmacies to be the vehicle to administer the vaccinations. We engaged and empowered communities to make the decision to get shots in arms. Those same principles apply to the world of clinical research.
I spent over 28 years in this space. As a daughter of a pharmacist, as a Southeast Asian woman, there’s not a lot of data out there today. Less than 5 percent of this nation participates in medical research. Of those that participate, three-quarters are Caucasian, which means the medications that are being dispensed out in our pharmacies don’t have the same health outcomes that they do in Black and Brown communities versus our Caucasian communities.
So for me, it was very important to come into the Walgreens ecosystem and build out a clinical research enterprise that would tackle two key areas. Number one: the lack of representation that exists in clinical research. Number two: accessibility.
We talk about how health care is not accessible for all the communities across the nation. Walgreens, having been in the communities for well over 100 years, has the trust and brand in the communities. We’re unlocking our physical footprint as a mechanism to drive clinical research and clinical trial services within our stores and pharmacies. … We know we can do more to tackle some of the care gaps that we’re seeing. So whether it’s looking at screening services or diagnostic blood draws, our goal is to make sure that we can provide those services.
What are the barriers to equitable access to clinical trials that you try to tackle?
At Walgreens, we have a lion’s share of communities that have never been educated about medical research or their participation in joining clinical trials and what that means for them. Just the awareness, the literacy issues, the digital gaps, technology gaps, broadband issues, I mean, you name it. This is not something new to our ecosystem. These barriers have been part of these communities for a very long time.
We’ve gone just beyond talking. We’re actually making stuff happen as we focus our investments in health care. On an average month, people come in four to five times to stores and pharmacies. Depending on the patient population, that may be the only go-to place to be able to have those conversations about their health and the impact that medication has on their bodies, particularly if there’s not a lot of research on Black and Brown communities.
We’re leveraging those relationships when our partners, like pharmaceutical companies, reach out to us and say, “Can you help us find patients to fulfill the commitments of the trials?” When they say, “We want to go into communities like the Deep South or in the rural parts of America,” they have to appreciate this is not easy. As we start to think about building the “highway” and start tackling some of those barriers, it’s [important to] spend time to educate, engage, and drive awareness so people feel empowered to make the decision to participate.
The narrative that we’re changing at Walgreens is that clinical research is a care option in your care journey, particularly if standard-of-care therapy is not a viable option for you. So as pharmacists start to have those conversations with their patient populations, we’re hoping the broader provider ecosystem is doing the same, because that is the first step of starting to tackle some of those barriers about mistrust, fear, lack of understanding and participation in medical research.
Walgreens has been doing this work with clinical trials for two years. What kind of headway are you making?
We have well over 35 clinical trials on the way. We’ve completed six where we’ve published case studies that show the role that pharmacies can play in tackling representation. Nearly 46% to 52% of patients that we’re enrolling are coming from underserved communities or communities of color.
We are partnering with big strategics like Boehringer Ingelheim, as we recently announced, on a Phase 3 obesity trial [with patients who have type 2 diabetes]. We’re excited about bringing the proof points and the body of evidence for the role that pharmacies can play in clinical research.
How do you think AI can support or impede health equity?
We’re seeing it firsthand as we’re delivering clinical trials into our communities. We’re using elements of AI to canvas our ecosystem to find the right patients and match those patients for trials so they have an opportunity, particularly in the underserved communities. However, I can assure you, AI is not going to convince Black and Brown patients to participate in clinical trials. It’s not happening. There’s a lot of educating and empowering of those patients [needed to get them] to come along the journey.
Some of your retail competitors in this space have been pulling back or out of clinical research. What are your thoughts on that? Is it disheartening to see?
It’s very disheartening. As we think about the health care ecosystem overall, physicians, nurses, all care providers have relationships. What we saw during the Covid pandemic, the pharmacist has such a critical and vital role to play. And so our colleagues in the retail pharmacy industry have all thought one thing, how do we bring clinical research trials closer to where the patient communities are? I think some of our colleagues ventured down this path, paved the path. And it’s regrettable that they discontinued, but certainly from Walgreens, we’re doubling down.
Our CEO says this is inherent in the DNA of our health care strategy. We firmly believe that as we provide health care services to all the communities that cut across our ecosystem, medical trial services is one of them as well.