A 22-year-old Wisconsin man died from an asthma attack after the price of his inhaler skyrocketed to over $500 and he was forced to choose to pay for rent over the “life-sustaining medicine,” his parents claim.
Cole Schmidtknecht’s family is demanding damages from Walgreens Pharmacy and United Health Group’s OptumRx for their alleged actions leading to the 2024 death, according to a lawsuit filed in federal court.
Schmidtknecht was diagnosed with chronic asthma as an infant but managed his symptoms with a daily dose of a corticosteroid inhaler for over a decade.
The Green Bay area truck center employee earned a “modest hourly wage” and had a self-insured plan with his employer through United Health Group, the lawsuit obtained by Law&Crime detailed.
His plan through OptumRx, a subsidiary of United Health Group, covered the corticosteroid inhaler Advair Diskus.
Through the plan, Schmidtknecht paid roughly $35 to up to $66.86 during the “deductible phase of the plan.”
Without insurance coverage, the lawsuit claims, the prescribed medication would cost Schmidtknecht over $530.
In the fall of 2023, OptumRx allegedly changed the list of drugs it would cover in 2024, with Advair Diskus being excluded from the covered medication.
The pharmacy care business is accused of not relaying its formulary of covered drugs to its customers, an alleged violation of Wisconsin law that requires such businesses to notify patients at least 30 days before coverage runs out.
The suit claims United Health Group is one of the three pharmacy benefit managers (PBMs) in the country, overseeing more than 79 percent of the fulfillment of drug prescriptions.
The Schmidtknechts accuse PBMs of artificially driving up health care costs in several ways, including forcing customers to choose the more expensive medication when there is a cheaper alternative on the market.
Schmidtknecht went to his local Walgreens connected with OptumRx to fill his prescription on Jan. 10, 2024, and was told the medication was no longer covered by his insurance.
The out-of-pocket cost for the inhaler was $539.19.
Schmidtknecht left the pharmacy without his medication.
The heartbroken parents claim Walgreens and its employees didn’t take the necessary steps to help Schmidtknecht find medication for his asthma.
They also attacked OptumRx for taking the inhaler and its generic counterpart off its formulary list knowing the patient would leave without the “necessary asthma medication his physician prescribed.”
Schmidtknecht relied on his old “emergency” inhaler to help his symptoms and began experiencing breathing difficulties over the five days after his trip to Walgreens.
During that time, Schmidtknecht chose to pay his rent instead of buying the medicine, Wisconsin Public Radio reported.
On Jan. 15, 2024, Schmidtknecht suffered a severe asthma attack and became asphyxiated.
His roommate rushed him to the local emergency room in Appleton, Wis.
Schmidtknecht fell unresponsive and pulseless during the car ride.
Hospital staff gave him two doses of epinephrine and performed CPR for four minutes.
He remained in a coma on a ventilator for six days until his parents were told “he was beyond help,” the lawsuit states.
Schmidtknecht’s parents took him off life support and he was pronounced dead on Jan. 21, 2024.
The family claims their son suffered damages of life, future earnings, physical and mental pain and suffering, and humiliation.
They also say they are seeking damages relating to the funeral expenses and that they lost society and companionship because of their son’s death.
Loss of society is a non-economic loss that loved ones can seek compensation for in a lawsuit.
“Loss of society and companionship” can be filed by close family members claiming that someone’s wrongful or negligent act took away the love, care, affection, guidance and protection of the victim, according to S. Burke Law.
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