In a tragic incident that underscores the critical issue of medication affordability, 22-year-old Cole Schmidtknecht from Wisconsin died after an asthma attack, which his family attributes to a sudden and unaffordable increase in the price of his inhaler. The Schmidtknecht family has filed a lawsuit against OptumRx, a pharmacy benefits manager, and Walgreens Pharmacy, alleging negligence and wrongful death.
Background
Cole had managed his chronic asthma since childhood using the Advair Diskus inhaler, with out-of-pocket costs ranging from $35 to $66.86. In January 2024, upon attempting to refill his prescription at a Walgreens in Appleton, Wisconsin, he was informed that his insurance no longer covered the medication, resulting in a new price of $539.19. Unable to afford this sudden increase, Cole left without his inhaler.
The Incident
Over the next five days, Cole relied solely on his rescue inhaler, which is intended for emergency relief rather than daily management. On January 15, 2024, he suffered a severe asthma attack. Despite being rushed to the emergency room by his roommate, Cole became unresponsive during the journey. Medical staff performed CPR and administered epinephrine, but Cole never regained consciousness. After six days on a ventilator, he was pronounced dead on January 21, 2024.
Legal Allegations
The lawsuit alleges that OptumRx violated Wisconsin law by failing to provide a 30-day advance notice of the medication’s price increase, depriving Cole of the opportunity to seek alternatives or exceptions. It also accuses Walgreens of negligence for not offering more affordable alternatives or contacting Cole’s physician to discuss other options. The family contends that both entities prioritized profits over patient health, leading to Cole’s untimely death.
Responses from Involved Parties
OptumRx expressed condolences to the Schmidtknecht family and stated that their actions were consistent with industry practices and the patient’s insurance plan design. They noted that Cole had filled a generic Albuterol prescription, a rescue inhaler, on the same day he was informed of the price increase. Walgreens has not provided a comment due to the ongoing litigation.
Broader Implications
This case highlights the broader issue of rising prescription drug costs and the challenges patients face in accessing essential medications. The Schmidtknecht family’s lawsuit seeks to address these systemic problems, emphasizing the need for transparency and accountability within the pharmaceutical and insurance industries.
Conclusion
Cole Schmidtknecht’s tragic death serves as a stark reminder of the potential consequences of unaffordable healthcare. It underscores the importance of ensuring that life-sustaining medications remain accessible to all patients, regardless of economic status. As the lawsuit progresses, it may shed light on the practices of pharmacy benefits managers and pharmacies, potentially prompting reforms to prevent similar tragedies in the future.
Sources:
apnews.com
people.com