Fox Valley family sues over son’s fatal asthma attack after medication cost increased 700 percent

Cole Schmidtknecht lived with chronic asthma since he was an infant, using an Advair Diskus inhaler daily to manage the pulmonary disease. 

The medication was covered by his health insurance, costing between $35 and $66.86 per month.

Until Jan. 10, 2024. 

That’s when a pharmacist at a Walgreens in Appleton told Cole the medication was no longer covered by his insurance. 

Without that insurance coverage, the out-of-pocket cost for the inhaler was $539.19. Cole left, without the medication or an option for a generic version.  

Five days later, Cole, 22, had a severe asthma attack. He died on Jan. 21, 2024. 

A new federal lawsuit filed by Cole’s parents, Shanon and Bil Schmidtknecht of Poynette, alleged the 700 percent increase in the cost of the inhaler caused their son’s death. 

Cole’s family said he chose to pay his rent instead of buying his medication. 

Cole’s family is suing Optum Rx, a subsidiary of United HealthCare, and Walgreens for wrongful death.  

Walgreens declined to comment, citing pending litigation. Optum RX did not respond to request for comment on the lawsuit. 

Since Cole’s death, the Schmidtknechts have been working with lawmakers to fight unfair practices by prescription drug benefit managers, or PBMs. 

Optum RX is one of the three largest PBMs in the country, along with Caremark Rx and Express Scripts. The companies administer about 80 percent of all prescriptions in the United States.

In September 2024, the Federal Trade Commission brought action against the three companies alleging they have abused their economic power by rigging pharmaceutical supply chain competition in their favor, forcing patients to pay more for life-saving medications. 

Cole’s family alleges in their federal complaint that Optum Rx did not give him the required 30 days notice about the cost increase of Advair Diskus.

“As a result, he did not have the opportunity to ask for an exception to the OptumRx’s reclassification of the medication under its formulary that suddenly made his normal medication prohibitively expensive,” according to the complaint. 

According to a statement by Optum Rx, it was the Walgreens pharmacist’s obligation to contact Cole’s prescribing physician about three other “clinically-appropriate” alternatives.

Walgreens did not provide Cole with more affordable workarounds, a generic alternative to Advair Diskus or contact his physician, according to the complaint. 

“Over the next five days, Cole repeatedly struggled to breathe, relying solely on his old ‘rescue’ inhaler to limit his symptoms, because he did not have a preventative inhaler designed for daily use,” the complaint states. 

On Jan. 15, 2024, Cole’s roommate drove him to the emergency room at ThedaCare Regional Medical Center-Appleton. When they arrived, he was unresponsive. 

“Emergency medical staff immediately gave Cole two rounds of epinephrin and performed two rounds of Cardiopulmonary Resuscitation, lasting over four minutes, to try to get him to regain consciousness,” according to the complaint. “Despite their best efforts, Cole never woke up again.”

Cole remained on a ventilator in the Intensive Care Unit for six days before his parents withdrew life support. 

Cole’s story was entered into the Congressional Record during a hearing for PBM Reform on Dec. 9 by U.S. Rep. Jake Auchincloss, D- Massachusetts. 

“Cole had his whole life ahead of him,” Auchincloss said. “Because Cole was forced to pay his rent, or shelling out hundreds of dollars to cover his medication out-of-pocket for a drug that did not need to be that expensive, his family is without their loved one.”