Independent community pharmacies generate some of the most clinically meaningful data in health care, yet the pharmacies often see the least benefit from this. Every day, they capture the real story of how medications perform once they leave controlled clinical trials and enter messy, real life.1-3 But as that information moves through switching networks, technology platforms, and analytics vendors, the value it creates tends to accumulate everywhere except where it begins—at the pharmacy counter.4-6
Each prescription filled, delayed, switched, or abandoned tells a story about whether a therapy works in the real world or only on paper. Did the patient walk away when they saw the co-pay? Did they quietly stop refilling after a bad adverse effect? Did a prior authorization or formulary change derail treatment entirely? When these events are captured and aggregated across thousands of pharmacies, they become a powerful lens on adherence, persistence, and outcomes in routine practice.2,3,7 For manufacturers and payers, this is gold—it is the “real-world evidence” they now insist on for pricing, market access, and coverage decisions.8-10
The irony is that independent pharmacies rarely see that gold. Instead, their data are siphoned off through pharmacy management systems, switching networks, wholesalers, and analytics vendors.4,11,12 Along the way, it is cleaned, packaged, and sold back to the market as high-value insight. Payers use it to fine-tune benefit designs and risk models, manufacturers rely on it to understand performance and support regulatory and commercial strategies, and consultants build entire business lines on top of it.7-10 Meanwhile, the average independent pharmacy might get a basic reporting dashboard—sometimes for an additional fee.
This is not just an unfortunate byproduct of modern health information technology; it is a deliberate architecture of control. Contracts are written so that vendors, not pharmacies, often hold the keys to the data.11,12 Default terms may allow broad secondary use. Export functions can be limited or awkward enough that many owners do not use them.11,13 Pharmacies are kept on the “user interface” side of the screen, while the real leverage happens behind the scenes in the data layer. The result is that those closest to patient behavior have the least power to act on it.
That power imbalance matters because pharmacies occupy the most human point in the medication journey. Prescribers decide what should happen. Payers decide what they will pay for. But pharmacists see what actually happens.14 They hear the patient whisper that they cannot afford their medication this month, notice the maintenance drug that has not been refilled since the deductible reset, and see when a patient on a complex regimen starts missing doses because they are overwhelmed.15-17 From a system perspective, that is the difference between theoretical care and real care.
Yet the system treats pharmacies less like partners in real-world evidence and more like data exhaust pipes. Their transactional feeds are pulled into massive real-world data warehouses that drive billion-dollar decisions, while many independents are fighting to keep the doors open.15-17 The message is clear: Your data are strategic; your survival is optional.
It does not have to be this way. The first step is to recognize pharmacy data for what they are: an asset, not a byproduct. Independent owners should be asking pointed questions of every technology and data partner they work with. Who can use our data, for what purposes, and with what financial benefit? Do we have the right to access raw, deidentified outputs that would let us analyze our own performance and patient outcomes? Are we being compensated, in any form, when our data feed commercial real-world evidence products?4-6 If the answer to these questions is “no” or “we are not sure,” that is not a neutral position—that is a transfer of value away from the pharmacy.
On the other side of the table, payers and manufacturers cannot have it both ways. They cannot call real-world evidence “transformative” and “indispensable,” build strategies on top of it, and then pretend that the entities generating much of that evidence are just interchangeable end points.8-10 If the industry genuinely believes community pharmacy is essential, then it should be prepared to share more than talking points. That means including independent pharmacies as named stakeholders in data collaborations, designing contracts that recognize their contributions, and returning actionable insights—not just aggregate benchmarks—that help them improve care and make a sustainable business case for clinical services.15-17
About the Author
Noah A. Chapman is the founder and CEO of Veridex Lab, a health care data infrastructure company focused on unlocking the value of real-world pharmacy data. He has more than 27 years of experience in pharmacy and health care operations, including leadership roles at Walgreens, CVS Health, Benzer Pharmacy, Pierce Pharmacy Management, and Capsule, where he led national market expansion and technology-enabled pharmacy services. He began his career in 1999 on the overnight shift at Walgreens and has spent his career working at the intersection of independent pharmacy, health systems, and data-driven care.
None of this suggests that identifiable patient information should become a new revenue stream. Patient privacy is not a bargaining chip. The line is clear: Identifiable data must be protected and used only under strict legal and ethical safeguards. But deidentified, aggregated intelligence derived from pharmacy operations is already being monetized at scale.4-6 The real question is whether the people who do the work of capturing that intelligence will continue to be treated as anonymous inputs or as partners with a legitimate claim to the value created.
Independent pharmacies have been told for years to “reinvent themselves” as clinical hubs, immunization centers, and chronic care extenders.15-17 Many have done exactly that, often under punishing financial conditions. What they have not been told—at least not honestly—is that they are also quietly functioning as unpaid data laboratories for the rest of the health care economy. If community pharmacy is going to survive, let alone thrive, that reality must change.
Who really owns pharmacy data? On paper, the answer may be buried in vendor contracts and terms of service. In practice, ownership has followed power and profit, not proximity to patients.18,19 The next phase of real-world evidence will show whether the industry is willing to rebalance that equation—or whether independent pharmacies will remain the only stakeholders expected to give everything and get almost nothing from the data revolution happening in their own stores.
REFERENCES
Dang A. Real-world evidence: a primer. Pharmaceut Med. 2023;37(1):25-36. doi:10.1007/s40290-022-00456-6
Roberts MH, Ferguson GT. Real-world evidence: bridging gaps in evidence to guide payer decisions. Pharmacoecon Open. 2021;5(1):3-11. doi:10.1007/s41669-020-00221-y
Masucci L, Lewis D, Zhao J, Carter C, Chan KKW, Wong WWL. The use of real-world evidence among healthcare payers: a scoping review. Int J Technol Assess Health Care. 2025;41(1):e67. doi:10.1017/S0266462325100445
Laurent A. Pharmacy management systems: a guide to software & vendors. IntuitionLabs. Updated February 24, 2026. Accessed March 24, 2026. https://intuitionlabs.ai/articles/pharmacy-management-systems-guide
Hernandez I, Tang S, Morales J, et al. Role of independent versus chain pharmacies in providing pharmacy access: a nationwide, individual-level geographic information systems analysis. Health Aff Sch. 2023;1(1):qxad003. doi:10.1093/haschl/qxad003
Abraham PA, Kannarkat JT, Qato DM. Reforming markets to strengthen independent pharmacies. JAMA Health Forum. 2025;6(4):e250142. doi:10.1001/jamahealthforum.2025.0142
