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The use of claims data in clinical research is gaining widespread acceptance by stakeholders, resulting in increased utilization by researchers in the real-world, late phase space. Coupled with technological advances and robust processes in data extraction, cleaning and integration with clinical data from electronic medical records, claims data hold the promise of potentially increasing the reliability of research results while simultaneously decreasing site and patient burden to participating in clinical trials. In this chapter, we explore diverse examples of how claims data can be used to design, implement and troubleshoot various issues in the pragmatic clinical trial space. Challenges and solutions are highlighted using examples from clinical trials in multiple therapeutic areas with the intent of continuing the discussion on how the use of claims data in clinical research can potentially be refined in the future.