• When the Cost of His Asthma Inhaler Went Up $500, His Parents Claim He

    From Leroy N. Soetoro@21:1/5 to All on Sat Feb 22 00:13:10 2025
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    XPost: alt.health.systems, talk.politics.medicine

    https://www.msn.com/en-us/health/medical/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/ar-AA1yAczn

    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

    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.

    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.”

    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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