Man’s asthma inhaler cost went from $66 to $539, then he died, Wisconsin lawsuit says
.png "Cole Schmidtknecht, 22, died from an asthma attack after his medication was no longer covered by his insurance company.")
The family of a Wisconsin man is suing after they say he died from an asthma attack when his medication price rose from $66 to $539.
Cole Schmidtknecht, 22, lived with chronic asthma since he was an infant, according to a lawsuit filed by his parents on Jan. 21 in Wisconsin federal court.
Schmidtknecht took daily doses of Advair Diskus to manage his asthma, the lawsuit said. His medication was covered by his employer-provided health insurance United Health-OptumRx Plan.
Under the healthcare plan, the Advair Diskus cost no more than $66.86, and at times as low as $35 “during the covered phase,” according to the civil complaint.
On Jan. 10, 2024, Schmidtknecht went to a Walgreens pharmacy in Appleton to fill a prescription from his physician when he was told that the medication was no longer covered by his insurance, the lawsuit said.
Schmidtknecht was told the medication would now cost $539.19 out of pocket.
The complaint said OptumRX did not give Schmidtknecht a 30-day notice of any change as Wisconsin law requires.
“As a result, he did not have the opportunity to ask for an exception to the OptumRx’s re-classification of the medication under its formulary that suddenly made his normal medication prohibitively expensive,” the lawsuit said.
OptumRx said in a statement that the Walgreens pharmacist should have contacted Schmidtknecht’s doctor “about three other ‘clinically-appropriate alternatives available at a Tier-1 (more affordable) Co-pay,’” the lawsuit said.
McClatchy News reached out to Walgreens and OptumRX on for comment Jan. 28 and was awaiting a response.
The complaint said Walgreens didn’t offer Schmidtknecht a generic option for medication and also told him there were no cheaper alternatives or generic medications available.
Schmidtknecht left Walgreens without the medication he needed, the lawsuit said.
“Over the next 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 complaint said.
On Jan. 15, 2024, he had a severe asthma attack, the lawsuit said. Schmidtknecht’s roommate rushed him to the hospital, but he became “unresponsive and pulseless in the car,” according to the complaint.
Schmidtknecht never woke up again, the lawsuit said.
On Jan. 21, Schmidtknecht’s parents took him off life support and he died.
The Schmidtknechts are demanding a jury trial and monetary damages, according to the complaint.
“Our hope is that this lawsuit and Cole’s death will lead them to kind of introspect on their own policies and change their policies going forward,” Schmidtknecht’s family attorney told WMTV.
Appleton is about a 30-mile drive southwest of Green Bay.
