The Value of the 340B Program: UK St. Claire Health Case Study

This case study was originally published by the American Hospital Association.

Who is UK St. Claire?

As the largest rural hospital in Eastern Kentucky, UK St. Claire is part of an integrated health system serving as the primary provider across 11 counties in the region and caring for 170,000 patients annually. Having grown from humble beginnings in 1963, UK St. Claire is now the largest employer in the region with more than 1,200 staff, including 125 physicians and 70 advanced practice professionals across 30 medical specialties.

UK St. Claire operates a multi-specialty medical pavilion, seven primary care locations, two urgent care centers, a pediatrics clinic, home health and hospice services, a counseling center, and a medical equipment and supplies store. Throughout the system, Eastern Kentuckians have access to specialty services such as cardiology, neurology, gastroenterology, pulmonology, and new endocrinology and vascular departments, making UK St. Claire an integral part of the community.

In addition to their traditional services, UK St. Claire offers a variety of community care programs made possible by their participation in the 340B Drug Pricing Program — a federal program that empowers qualifying hospitals to purchase certain outpatient drugs at a discounted price and develop programs that advance health in their communities. At UK St. Claire, this includes services like the Chronic Care Program to help patients access medications and the Pastoral Care Program to ensure patients have access to follow-up care after a hospital discharge.

"The 340B Drug Pricing Program is crucial to our ability to serve Eastern Kentucky's most vulnerable patients. By enabling us to provide discounted medications, rehabilitation services, and other life-saving services, we are able to ensure that everyone in our community receives the care they need," Caitlin Guerin, Pharm D, UKSC Director of Pharmacy.

Who UK St. Claire Serves

UK St. Claire serves some of Eastern Kentucky’s most rural patients, providing care that would otherwise require up to 7 hours of driving to access. Many patients in the area live with multiple chronic conditions that require regular specialty care; moreover, many residents in the area are under- or uninsured. UK St. Claire is committed to providing care to patients across their service area, no matter their ability to pay, and relies on savings from the 340B Drug Pricing Program to reach patients who are otherwise unlikely or unable to access care.

340B Program Benefits Our Patients

The 340B Drug Pricing Program ensures patients can access services like addiction recovery support, oncology services, and medication assistance programs. Without these programs, many patients would not receive this level of care, which could worsen health outcomes for our communities. UK St. Claire’s participation in the 340B program makes it possible to reach patients with limited care options — the goal Congress set for this program at

its outset more than 30 years ago.

By participating in the 340B Drug Pricing Program, UK St. Claire can offer many services that directly benefit their patients, including:

• Rehabilitation and Addiction Recovery Care. Kentucky has been ravaged by the addiction and overdose epidemic. By partnering with local rehabilitation and recovery centers, UK St. Claire is helping patients struggling with substance use disorder (SUD) access treatment. After the initial detox process — which is done in a UK St. Claire facility — patients may choose a local rehabilitation partner for their continued recovery. UK St. Claire supplies medication free of cost to local recovery centers to ensure SUD patients can access prescription treatment no matter their insurance coverage or financial situation. Last year, more than 4,500 prescriptions were provided to local recovery centers by this program — all at no cost to patients and local rehab centers. UK St. Claire further supports patients’ recovery by offering second-chance employment within their health system and partners with local community colleges to provide educational resources to patients as they get back on their feet. These efforts help reduce stigma around SUD and improve patient health and well-being following treatment.

• Oncology and Infusion Services. UK St. Claire’s new oncology clinic provides oncology infusion services to more than 26,000 patients every year. Because of the remote geography of the region, without UK St. Claire to offer these services, patients would have to drive several hours to receive similar services. For many patients, this would prove improbable, if not impossible, leading to poorer outcomes. Sadly, many patients would likely be forced to skip or discontinue their life-sustaining oncology infusion treatments.

• Medication Access Assistance. Established under the hospital’s ambulatory care department and pharmacies, UK St. Claire’s Chronic Care Program helps more than 1,000 patients per year access their medications for only $5, $10 or $20 — compared to $150 or more for drugs like anti-coagulants. In 2023, the Chronic Care Program provided nearly 4,500 prescriptions at no- or low-cost to patients –– keeping them healthier, more independent and out of the hospital.

“Without the savings from the 340B program, many of the essential services we provide, like oncology treatment and addiction recovery support, would be unsustainable. This program truly allows us to fulfill our mission of compassionate, accessible care for all," Caitlin Guerin, Pharm D, UKSC Director of Pharmacy.

340B Hospitals like UK St. Claire Need Support

With the looming threat of fundamental changes to the 340B Drug Pricing Program, hospitals like UK St. Claire — and their patients and communities — are at risk. Hospitals and health systems need the support of the 340B program to help fund vital community programs, services and initiatives. The unfortunate truth is that without 340B, UK St. Claire may not be able to provide life-changing addiction rehabilitation, cancer care, and other essential services to Eastern Kentuckians.

Lawmakers can prevent patient benefits and community health programs from being eliminated by maintaining their strong support for the 340B Drug Pricing Program.