When the Cost of His Asthma Inhaler Went Up $500, His Parents Claim He Couldn't Pay. Two Weeks Later He Was Dead at 22
Cole Schmidtknecht, 22, couldn't pay for his daily inhaler due to the “prohibitively expensive” price increase, but then he died of an asthma attack, per a lawsuit filed by his parents
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Cole Schmidtknecht was 22 when he died of an asthma attack.The parents of Cole Schmidtknecht, 22, are suing his medical insurance company and pharmacy after he died of an asthma attack, allegedly due to the new cost of his inhaler
The price of Cole's inhaler increased $500, and he was unable to afford it, according to the complaint
Shanon and William Schmidtknecht’s lawsuit alleges that Cole was neither informed of the price increase nor offered generic alternatives
A Wisconsin couple is suing their son’s insurance company, Optum Rx, and Walgreens pharmacy for alleged negligence and unspecified damages after their son died of an asthma attack — less than two weeks after he stopped taking his maintenance inhaler — allegedly due to a $500 price increase.
Cole Schmidtknecht, 22, had a lifelong struggle with asthma, according to the lawsuit filed by Shanon and William Schmidtknecht, of Poynette, Wisc. He managed his symptoms with Advair Diskus — the brand name for fluticasone and salmeterol, medications that help control the symptoms of asthma when taken daily. GSK, the manufacturer of Advair, is not named in the lawsuit.
Cole’s prescription had been covered under his insurance, Optum Rx, which is owned by UnitedHealth Group, the lawsuit alleges. Previously the medication had cost no more than $66.86 (without deductible) and $35 (with deductible).
However, on Jan. 10, 2024, when Cole arrived at his usual Walgreens pharmacy, the suit alleges that he was told his medication was no longer covered and he needed to pay out-of-pocket a total cost of $539.19.
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Cole Schmidtknecht was informed his medication was no longer covered at this Walgreens in Appleton, Wisc.Cole was allegedly not given a 30-day notice by Optum Rx that his medication — nor its generic forms — would no longer be covered, the suit alleges. Lawyers for the plaintiff said he was not given enough time to request an exception to the new guideline that “suddenly made his normal medication prohibitively expensive.”
According to the lawsuit, Optum Rx says Walgreens should have contacted Cole’s doctor for a covered alternative, but “did not follow these instructions.”
Cole was also allegedly not provided with a “free or discounted” inhaler to use while he reached out to his provider. Instead, the suit alleges Walgreens “further told Cole that there were no cheaper alternatives or generic medications available.”
“Because Cole could not afford this unexpected expense of $539.19, he left the Walgreens without filling his prescription,” the suit claims.
Without his daily inhaler to help control the symptoms of asthma, the suit says Cole’s breathing deteriorated over the next five days, forcing Cole to rely on his rescue inhaler to relieve his symptoms.
Optum Rx previously provided a statement to Fox47 regarding Cole Schmidtknecht’s death, telling the outlet “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. "
Albuterol is commonly called a "rescue" inhaler, used to stop attacks while they're happening, and differ from maintenance medication like Advair.
According to the complaint, “On January 15, 2024, five days after visiting the OptumRx-Walgreens pharmacy, Cole had a severe asthma attack and began to asphyxiate.” His roommate drove Cole to the emergency room, but while in the car, Cole became “unresponsive and pulseless.”
In the emergency room, Cole appeared blue, the suit says, and was given emergency treatment but “despite their best efforts, Cole never woke up again.”
After six days on a ventilator, doctors told his parents that he was “beyond help” and on Jan. 21, they withdrew life support. His cause of death was allegedly status asthmaticus, which the National Library of Medicine describes as “an extreme form of asthma exacerbation”
The lawsuit describes the actions of Optum Rx and Walgreens as “grievous and outrageous,” and that both companies were “aware that the result or consequence of serious injury or death was substantially certain to occur when it violated State law and acted in intentional disregard of that serious injury or death.”
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Stock image of Advair.Related: Broadway Star Laurel Griggs, 13, Tragically Died of an Asthma Attack: Here's How That Can Happen
Optum Rx's previous statement continued, "Optum Rx 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.”
“Our goal is to ensure medicines, including those used to treat asthma and other critical conditions, are accessible and affordable for Americans. After rigorous review of this case, we determined that formulary management and communications efforts that impacted this patient’s access to key asthma medication options were handled consistent with industry practice and the patient’s insurance plan design. Any members with questions about their coverage can call the number on their prescription card.”
PEOPLE has reached out to Optum Rx for more information.
A representative for Walgreens told PEOPLE via email, “We can’t comment due to pending litigation.”
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