Community, Hospital, and Online Pharmacies in Bharat: A Missed Opportunity for Scalable Health Research

Abstract

Bharat possesses one of the world’s largest networks of community, hospital and online pharmacies, yet this infrastructure remains substantially underutilized for formal health research. The central problem addressed in this perspective is the persistent gap between pharmacy practice and systematic research generation, despite routine access to large, diverse patient populations and longitudinal medication data. While pharmacies are deeply embedded in daily healthcare delivery, their potential contribution to real-world evidence generation – particularly in drug utilization, antimicrobial stewardship, pharmacovigilance, and health economics – remains insufficiently leveraged, contributing to a critical gap in decentralized health data from low- and middle-income settings. Emerging Indian evidence demonstrates that community pharmacy settings can generate clinically and economically relevant data, including prescription patterns, antibiotic utilization, and cost analyses. However, such studies remain limited in scope and scale. In addition, operational evaluations of public pharmacy initiatives highlight systemic and economic challenges affecting service delivery. International experiences further indicate that pharmacy-linked policy interventions may influence drug utilization patterns, particularly the uptake of generics. This perspective proposes that systematic integration of community and hospital pharmacies into structured, ethically governed research frameworks – led by academic institutions and supported by national regulators – may strengthen evidence generation in a scalable and context-appropriate manner. Rather than presenting definitive outcomes, this article advances a policy proposition for repositioning pharmacies as decentralized research nodes within Bharat’s evolving health research landscape.