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A 22-YEAR-OLD man is dead after suffering an asthma attack when the price of his inhaler skyrocketed and he could no longer afford it.
And now, his family is suing his medical providers for forcing him to choose between his rent and his health.
Cole Schmidtknecht managed his chronic asthma using an Advair Diskus inhaler daily for more than a decade, as reported by Newsweek.
Schmidtknecht’s medication usually cost him between $35 and $66.86, according to the lawsuit.
But in 2023, OptumRX, a pharmacy benefits manager and subsidiary of United Healthcare, changed its policy.
As a result, Schmidtknecht’s daily inhaler was no longer covered under his insurance.
With no help from his insurance company, Schmidtknecht could not afford to pay the new cost of his inhaler: $539.19.
“The insurance company changed the formulary, raised the price of it to over $500,” William Schmidtknecht, Cole’s father, told local news NBC’s Wisconsin affiliate, WMTV.
“He walked out. Chose rent over his medicine.”
“Cole was a ‘fight for the little guy’ kind of person, definitely a fight for what he believed was right type of person,” said his mother, Shanon Schmidtknecht.
“So now we’re trying to take that and fight on his behalf.”
Schmidtknecht’s family is suing OptumRX Inc., Walgreens Pharmacy, and its parent company Walgreens Boots Alliance Inc., according to the legal documents.
OptumRx is one of America’s three largest pharmacy benefit managers (PBMs), which handles drug prescription claims for nearly 70 million Americans.
The family claims that the PBM failed to give their son the required 30-day notice about the cost increase of his inhaler, as stated in the lawsuit.
“As a result, he did not have the opportunity to ask for an exception to the OptumRx’s reclassification of the medication under its formulary that suddenly made his normal medication prohibitively expensive,” the lawsuit reads, according to WMTV.
Without access to his inhaler, Schmidtknecht was having a difficult time breathing.
“Cole was a ‘fight for the little guy’ kind of person, definitely a fight for what he believed was right type of person. So now we’re trying to take that and fight on his behalf.”
Shanon Schmidtknecht
For five days, he struggled to breathe – until January 15, 2024, when he had an attack so severe that his roommate drove him to a nearby emergency room.
Schmidtknecht became unresponsive in the car just minutes away from the hospital, and although medical staff tried to resuscitate him, they were unsuccessful.
Schmidtknecht remained on a ventilator in the Intensive Care Unit for almost a week before his parents chose to withdraw life support, as reported by WMTV.
There are several reasons why pharmaceutical drugs are becoming unbearably expensive.
These companies claim that researching and developing new drugs requires a lot of money, but this has not affected the price of the medicine itself.
Studies show that even after R&D spending, the top 30 pharmaceutical companies still make billions of dollars in profit.
Not to mention, the very same drugs typically cost far less in other countries than they do in the United States.
Walgreens and Optum RX did not respond to The U.S. Sun’s request for comment on the lawsuit.
