The Cost of His Inhaler Spiked 700%. He Died Days Later

The family of a young Wisconsin man is suing after they say his health insurance abruptly dropped coverage for a much-needed asthma inhaler, which they say helped lead to his death days later. Per the complaint filed by the family of Cole Schmidtknecht and cited by ABC News, the 22-year-old went to a Walgreens in Appleton on Jan. 10, 2024, to fill a prescription for an Advair Diskus inhaler, which had allegedly cost him no more than $66 in the past. On this visit, however, Schmidtknecht was told that Optum Rx, a pharmacy benefit manager (PBM) and subsidiary of UnitedHealthcare, had ceased coverage for that particular medication, which would now cost him $539.19 out of pocket, per the suit.

Schmidtknecht's family says he couldn't afford that for his preventive inhaler—they tell WPR he needed the money he had on hand to pay rent—so he instead purchased a rescue (ie, emergency) inhaler that only had a $5 co-pay. Just five days later, he ended up in the ER from a severe asthma attack, becoming "unresponsive and pulseless in the car" as his roommate rushed him to the hospital, per the complaint. Schmidtknecht never came to and died on Jan. 21. His family's suit says Schmidtknecht was never given the month's notice required under Wisconsin law about the insurance coverage changes so that he'd have time to explore alternatives with his doctor, per the Post Crescent.

The complaint—which accuses Walgreens, parent company Walgreens Boots Alliance, and Optum Rx of negligence and wrongful death—also alleges that Walgreens employees didn't offer Schmidtknecht any generic or other affordable alternatives or reach out to his doctor. Walgreens hasn't commented, citing pending litigation. In a statement, Optum Rx said the Walgreens pharmacist should've reached out to Schmidtknecht's doctor to check on three other "clinically appropriate" alternatives, per WPR.

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"There's nothing that's going to bring Cole back," dad Bil Schmidtknecht tells the Post Crescent. "'Justice' is probably monetary at this point, or whatever you want to call that. But it's not even about that. If we can be successful in this lawsuit, maybe it'll bring change." More here on what the Schmidtknecht family calls the "oligopoly" of PBMs. (More asthma stories.)