The parents of 22-year-old Cole Schmidtknecht are suing his health insurance provider, Optum Rx, and Walgreens pharmacy after their son died from an asthma attack. The lawsuit alleges that a significant price increase for Cole’s maintenance inhaler, Advair Diskus, prevented him from affording the life-saving medication. The price reportedly jumped from under $70 to over $500, leaving Cole unable to continue his treatment.
Cole, who had battled asthma his entire life, relied on Advair Diskus to manage his condition. The medication, a combination of fluticasone and salmeterol, helps prevent asthma symptoms when taken regularly. The lawsuit claims that Cole’s insurance, Optum Rx, had previously covered the prescription with a minimal copay.
According to the complaint filed by Cole’s parents, Shanon and William Schmidtknecht, Cole was not informed about the price increase or offered any generic alternatives when he went to fill his prescription at Walgreens on January 10, 2024. He was reportedly told the medication was no longer covered and would cost $539.19 out-of-pocket.
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The lawsuit contends that Optum Rx failed to provide the required 30-day notice of the coverage change, leaving Cole without sufficient time to seek an exception or explore other options. It also alleges that Walgreens did not follow Optum Rx’s instructions to contact Cole’s doctor for a covered alternative and did not offer him a temporary, free or discounted inhaler. Unable to afford the new price, Cole left the pharmacy without his medication.
Over the next five days, Cole’s condition worsened, forcing him to rely solely on his rescue inhaler, Albuterol. On January 15, 2024, he suffered a severe asthma attack. His roommate rushed him to the hospital, but Cole became unresponsive and pulseless en route. Despite emergency treatment, he never regained consciousness and died on January 21, 2024, after being taken off life support. The cause of death was determined to be status asthmaticus, a severe and life-threatening asthma exacerbation.
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Optum Rx, in a previous statement, expressed sympathy for Cole’s family but maintained that their actions were consistent with industry practices and Cole’s insurance plan. They stated that Cole filled a generic Albuterol prescription on January 10th with a $5 copay. However, Albuterol is a rescue inhaler used to treat acute asthma attacks, not a preventative medication like Advair Diskus. Optum Rx also asserted that they offer affordable alternatives to Advair Diskus with copays as low as $5. Walgreens declined to comment, citing pending litigation. The lawsuit seeks unspecified damages for negligence and alleges that both companies acted with disregard for Cole’s life.
