...
By Jasmine Laws
Reporter
0
Share
Newsweek is a Trust Project member
See more of our trusted coverage when you search.Prefer Newsweek on Googleto see more of our trusted coverage when you search.
A 22-year-old man died from an asthma attack after the price of his medication rose by almost $500, according to a lawsuit filed by his parents to a Wisconsin federal court.
Cole Schmidtknecht's family is seeking damages against the pharmacy benefits manager OptumRx Inc., Walgreens Pharmacy and its parent company Walgreens Boots Alliance Inc. and a jury trial, according to the filing.
Newsweek has contacted Walgreens via email for comment.
Read More on News
Why It Matters
Health insurance companies have come under significant scrutiny in recent months after the assassination of United Healthcare CEO Brian Thompson, with some accusing companies of treating customers unfairly.
What To Know
Schmidtknecht had had chronic asthma since he was a child and had used a steroid inhaler to control his symptoms for more than a decade, according to the lawsuit.
It detailed that his health insurance was covered by his employer, Kriete Truck Center Green Bay, and his pharmacy benefits manager (PBM) was OptumRx. A PBM acts as middleman between health insurers, prescription drug companies, and pharmacies.
According to the lawsuit, OptumRx is one of the nation's three largest PBMs and services drug prescription claims for more than 66 million Americans.
Schmidtknecht's medication typically cost him $66.86, according the lawsuit. However, OptumRx changed its formulary in the fall of 2023, meaning that it no longer covered the brand of inhaler that the 22-year-old used to manage his condition, the lawsuit read.
A formulary is a list of prescription drugs that an insurance plan or pharmacy benefit manager (PBM) covers and offers to its members.
When he went to collect his prescription at a Walgreens pharmacy in Appleton, Wisconsin, on January 10, 2024, the pharmacist informed him his prescription would now cost him $539.19 as it was no longer covered by his health insurance, the lawsuit added.
The lawsuit read that he was given no notice that his prescription would no longer be covered, and that Wisconsin law determines that he should have received 30 days' notice of the change.
As he could not afford the new cost of his medication, Schmidtknecht left the store without his inhaler, the filing said.
The lawsuit said that, according to a statement by OptumRx, the Walgreens pharmacist should have contacted Cole's prescribing physician about three other "clinically-appropriate alternatives available at a Tier-1 [more affordable] Co-pay."
The lawsuit added that instead the pharmacist "never provided Cole with any more affordable workarounds to obtain his usual inhaler for his chronic asthma."
Over the following five days, Schmidtknecht "repeatedly struggled to breathe, relying solely on his old 'rescue' (emergency) inhaler to limit his symptoms, because he did not have a preventative inhaler designed for daily use," the lawsuit read.
On January 15, 2024, he had a severe asthma attack and began to asphyxiate and his roommate drove him to the hospital. Two minutes before they arrived, he became unresponsive.
When he was seen by the emergency response practitioners, they recorded that he was "unconscious, pulseless, and appeared blue."
Despite their efforts to resuscitate him, Schmidtknecht "never woke up again," the lawsuit read.
On January 21, Schmidtknecht's parents took him off life support and he was pronounced dead.
...
What People Are Saying
Shanon Schmidtknecht, Cole's mother, told local news channel WMTV 15: "Cole was a very free-spirited kid."
She also reportedly said when testifying in front of the Federal Trade Commission in the summer of 2024, according to WMTV 15: "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."
William Schmidtknecht, Cole's father, told local news channel WMTV 15: "The insurance company changed the formulary, raised the price of it to over $500. He walked out. Chose rent over his medicine."
Michael Trunk, a partner at Kline & Specter and one of the lawyers representing the family, shared the following statement with Newsweek when asked for comment: "The conduct of both OptumRx and Walgreens was deplorable. The evidence in this case will show that both OptumRx and Walgreens put profits first, and are directly responsible for Cole's death."
Trunk added that Cole's parents hope that, through this lawsuit, the death of Cole can be an impetus for change in what is a deeply flawed health system.
OptumRx released an earlier public statement: "We are saddened by Cole's story and our sympathies are with his family and loved ones. We have reviewed his claims history and can confirm that he did fill a generic Albuterol prescription, an inhaler used to stop asthma attacks, on January 10, 2024, with a $5 copay.
"The same drug was previously filled in October 2023 by the member. OptumRx also has available clinically appropriate options and formulary information when a medication is not covered on formulary, including Advair Diskus formulary alternatives with member copays as low as $5."
John Walsh, Executive Vice President of Marketing and Communications of Kriete Truck Centers, shared the following statement with Newsweek: "We worked diligently to ensure that the new plan matched the previous year's plan as closely as possible. Our thoughts and hearts remain with Cole and the Schmidtknecht family."
What Happens Next
Cole's parents are seeking compensatory and punitive damages from all the defendants of the case for negligence and wrongful death, and the case is proceeding before U.S. District Judge Byron Browning Conway who was appointed by former President Joe Biden, according to Law and Crime.
Update 02/03/2025, 11:09 a.m. ET: This article was updated with comment from Michael Trunk
Update 02/04/2025, 11:27 a.m. ET: This article was updated with a previous public statement from OptumRx
Update 02/06/2025, 07:36 a.m. ET: This article was updated with comment from Kriete Truck Centers
View 0 Comments
Submit Correction
View Editorial & AI Guidelines