The Future of Clinical Trials: A Q&A with Alum Ramita Tandon.

The Future of Clinical Trials: A Q&A with Alum Ramita Tandon
As the chief clinical trials officer for Walgreens, alum Ramita Tandon discusses her efforts to decentralize and diversify drug research, as well as the strategies that have fueled her career.
Over the past 25 years, Ramita Tandon has helped build patient-focused businesses and accelerate the delivery of novel, cutting-edge treatments. She has worked as the chief operating officer at a small healthcare startup and in senior leadership at large multinational clinical research companies. Most recently, she was entrusted with leading Walgreens’ new clinical trials enterprise.
But before she advanced through the ranks of the corporate world, Tandon was an MPH student at the School of Public Health, an experience she credits with first introducing her to the problems facing the US healthcare industry.
“The public health curriculum [at SPH] gave me that base. It broadened my appreciation of the overall healthcare landscape,” said Tandon (SPH‘98, MED‘00), whose work at Walgreens aims to reimagine the way clinical trials engage and serve patients. The student, who was once new to the industry and became a knowledgeable insider, now wants to disrupt it.
Tandon studied biology at the University of Michigan and moved to Boston in the late 90’s when the area was experiencing a burst of early growth in the healthcare and biotechnology industries. She had been on a pre-med track in undergrad but was interested in learning more about drug development. While studying at SPH, she took a position with a research group at Boston Children’s Hospital, where her responsibilities included engaging with the National Institutes of Health (NIH) and applying for research funding. It was her first foray into understanding the lengths it took to bring a novel drug, device, or diagnostic into the hands of a patient—a process she says can sometimes take upwards of 10 to 12 years.
Shocked by the inefficiencies plaguing drug development research, Tandon felt compelled to do something, but she still envisioned a future in medicine or academia. It was not until someone from a clinical research organization approached her at a conference and half-jokingly asked, “Have you ever thought about coming to the ‘dark side?’” that she began her transition to industry, she says.
Tandon has since been named to the 2018 PharmaVoice Top 100, Drug Store News’ 2022 “Top Women in Health, Wellness & Beauty” for Business Excellence, Fierce Healthcare’s 2022 “Women of Influence,” and Pharmacy Podcast Network’s 2022 “50 Most Influential Leaders in Pharmacy.” Her demonstrated leadership captured the attention of Walgreens’ CEO Rosalind Brewer, who offered Tandon the role of chief clinical trials officer in late 2021, shortly after announcing the organization’s move into healthcare.
While Walgreens traditionally focused on retail pharmacy over the course of its 120-year history, the clinical trials business is one of several new ventures the company has debuted as it expands alongside competitors, such as Amazon, Walmart, and CVS, into the booming values-based care market. Currently valued at $500 billion, the market is projected to reach $1 trillion by 2027.
Increasingly popular as an alternative to the long-dominant fee-for-service model, the values-based care model ties providers’ compensation to the quality rather than the quantity of services delivered, which its proponents contend fosters more accessible, efficient, and effective healthcare. Tandon says Walgreens’ move into healthcare is intended to help tackle the issues facing the industry around equity and diversity as well.
So far, Walgreens has spent approximately $14 billion on investments in specialty pharmacy, primary care, and home care, reports Tandon. Additionally, Walgreens has converted about 250 of its retail pharmacies into “healthcare destination hubs” where community members can do more than just pick up prescriptions. The hubs also offer health screenings and a range of other diagnostic services.
The clinical trials business is a “start-up within the Walgreens’ mothership,” says Tandon. “We don’t have clinical trials yet, but as we deliver healthcare services through our locations, we can start offering clinical trials as an option for patients who are on standard of care therapy that’s not working, and they can get access to innovative research, drugs, and diagnostics that could actually help impact their health outcomes and quality of life.”
Tandon shared with SPH what all the buzz around decentralized clinical trials is about, and how she ended up at the helm.
Q&A
With Ramita Tandon
What does the role of Chief Clinical Trials Officer for Walgreens entail?
During the COVID-19 pandemic when everything was shut down, provider systems and settings were all shut down, the retail pharmacies—through the Trump administration—were asked to step up to deliver [COVID] vaccinations across the US. Over 400 million [COVID] vaccinations were delivered through the retail pharmacy ecosystem. That was a huge lesson learned for the company about health care and the fragmentation that exists at the community level. Given our physical footprint, we said we can start to do more in the area of health care and start to move away from this fragmentation, create more interoperability, and start delivering health care more locally, using our physical footprint to do so.
It’s been about one year since our CEO joined the company and made the announcement that Walgreens was moving into healthcare and, essentially, our focus [in clinical trials] is partnering with manufacturers, big pharma companies, healthcare systems, and government agencies, like NIH and BARDA [Biomedical Advanced Research and Development Authority], who have clinical trials. We want to leverage our ecosystem to support finding patients and use our locations as clinical trial centers. We are trying to disrupt the clinical trial engine and make it more patient-centric and accessible.
“Less than 5% of the US population participates in clinical trials and of those that participate, 75% are Caucasian, which means the drugs and the new therapies that are approved on the marketplace are not representative of the US population.”
What are the advantages of this decentralized approach to clinical trials for patients? How would they have traditionally been involved in clinical trials and how this is different?
Today and historically, the industry has relied on provider organizations or physician settings to help identify patients, and it’s been a challenge because of the time it takes for most providers or physicians to find patients, particularly if they’re busy and then you’re tacking on research to their workflow. The amount of money that manufacturers or pharmaceutical companies spend on finding patients is probably the most investment that they make and unfortunately, that cycle time to find patients has been a big issue as we think about the overall drug development life cycle. [Walgreens] is flipping the switch, if you will, because number one, we have access to 120 million lives across the nation, so, because of our direct access to patient communities and to the consumer, we have the ability to identify patients and match those patients to trials a lot quicker.
Also, the 2023 omnibus spending bill, signed last December, now has a provision that mandates manufacturers to diversify their clinical trials. Less than 5% of the US population participates in clinical trials and of those that participate, 75% are Caucasian, which means the drugs and the new therapies that are approved on the marketplace are not representative of the US population. So, a retail pharmacy like Walgreens that has access to diverse patient populations, we’re enabling this research to be accessible to everybody.
We’re not here to say we are disrupting the provider-patient relationship, but rather, we want to be a support mechanism in this entire clinical trial ecosystem that allows patients an opportunity to learn and feel comfortable that, ‘Hey listen, you know what? I now know what a clinical trial is,’ so they’re being educated and empowered to make a decision to participate.
How will Walgreens identify potential clinical trial participants?
When we get a clinical trial inquiry or an actual study that comes into our ecosystem, a couple of things happen first and foremost. As Walgreens, we have access to direct information on the patient’s pharmacy records, so we have a lot of information on your demographics. And through a partnership, we have access to over 300 million EMR [Electronic Medical Record] records, which is a patient’s clinical records. We’ve made the investments to bring together the pharmacy records as well as the clinical records, to create more of a holistic appreciation of the patient’s treatment journey, so upfront, we are able to identify the cohort of eligible patients for a particular disease area.
If it’s a diabetes clinical trial and a manufacturer is looking to enroll 15,000 type 1 diabetes patients, within a matter of a few hours, we’re able to identify by zip code, race, ethnicity, and other social insurance information on the patient population that could be eligible for that clinical trial. We then have created a workflow that allows us to safely and compliantly reach out to the patient population that’s deemed eligible and solicit their interest. Certainly, if they’re not interested to learn more, they’re able to opt out, so whether it’s texting, emailing, snail mail, or even phone calls—we’re making the outreach.
Once they’ve said, “Yes, we’re interested to learn more,” and once we deem them fully eligible, we then give them the options to participate, whether they come into our locations to do the clinical trial visit, it could be a screening, a diagnostic, or even lab draws; we can do it hybrid, where some of the aspects of the clinical trial can be done remotely, so telehealth; and then depending on where it makes sense, we can deploy aspects of the clinical trial activities at a patient’s home. We, ultimately, can offer a flexible set of options for a patient, if they’re deemed eligible and they’re willing to participate.
What keeps you engaged in your work?
If you’re in healthcare, it is evolving fast and furious—it is a $4 trillion market. Technology is certainly disrupting the healthcare ecosystem more so than it did 20 years ago. One piece of advice I give to folks is that you just don’t sit on the laurels of what you’ve learned. You’ve got to keep pushing yourself and learning because you’ve got to ideate and innovate as you start to build your repository of information and become a value-add to an individual organization, or if you decide to create your own start-up or your own organization.
I’ve spent about 25-plus years in the life sciences space, and I’ve had the pleasure of building businesses, leading large organizations focused on using different innovative emerging technologies, and disrupting the drug development lifecycle. If there are unique or faster and more cost-effective ways to accelerate this process, that’s been my platform and my “why” for doing what I’m doing.
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