A Wisconsin couple’s lawsuit against Walgreens and OptumRx over their son’s asthma-related death exposes critical flaws in healthcare affordability and pharmaceutical pricing practices.
Key Takeaways
- Wisconsin parents are suing Walgreens and OptumRx after their son died following an unaffordable price increase for his asthma medication.
- The lawsuit claims the medication cost jumped from $66 to $539 without proper notice, violating Wisconsin law.
- The case highlights the role of pharmacy benefit managers as intermediaries and raises questions about prioritizing profits over patient care.
- This tragic incident underscores the urgent need for transparency and accountability in pharmaceutical pricing.
Tragic Consequences of Medication Price Hike
On January 21, 2025, a Wisconsin couple filed a federal lawsuit in Milwaukee against Walgreens and OptumRx, marking the one-year anniversary of their son’s untimely death. Cole Schmidtknecht, a 22-year-old who had battled lifelong asthma, lost his life due to what his parents claim was an unexpected and unaffordable price increase in his essential medication.
According to the lawsuit, Cole had successfully managed his condition with daily doses of Advair Diskus and its generic equivalents. However, on January 10, 2024, he was confronted with a shocking reality at his local Walgreens pharmacy: the cost of his medication had skyrocketed from $66 to $539. Unable to afford this steep increase, Cole was forced to rely solely on a rescue inhaler, a decision that tragically led to a fatal asthma attack just days later.
Legal Claims and Ethical Concerns
The lawsuit brings several serious allegations against both OptumRx and Walgreens. It accuses OptumRx of violating Wisconsin law by dramatically increasing the medication price without a valid reason and failing to provide the required 30-day notice for such an increase. This abrupt change left Cole without access to his life-saving medication.
“The conduct of both OptumRx and Walgreens was deplorable,” one of the family’s attorneys, Michael Trunk, said in a statement. “The evidence in this case will show that both OptumRx and Walgreens put profits first, and are directly responsible for Cole’s death.”
The lawsuit also targets Walgreens, claiming that their staff failed to offer Cole alternatives or contact OptumRx or his doctor for an exception. This alleged lack of action raises questions about the pharmacy’s responsibility to ensure patients have access to critical medications.
The Role of Pharmacy Benefit Managers
This case sheds light on the complex and often opaque world of pharmacy benefit managers (PBMs) like OptumRx. These entities serve as intermediaries between health insurance companies, drug manufacturers, and pharmacies. While they claim to help manage costs, critics argue that their practices can sometimes lead to sudden and significant price increases for consumers.
In response to the lawsuit, OptumRx stated that Cole had purchased a different asthma medication, generic Albuterol, for a $5 co-pay on the day he visited the pharmacy. They asserted that this was “consistent with industry practice and the patient’s insurance plan design,” the company said.
However, the family’s attorney clarified that the $5 prescription was for a rescue inhaler, not the daily Advair Diskus inhaler that Cole needed to manage his condition effectively. This distinction highlights the importance of understanding the specific medical needs of patients and the potentially life-threatening consequences of medication substitutions.
A Call for Accountability and Change
The lawsuit seeks unspecified damages, accusing both OptumRx and Walgreens of prioritizing profits over patient care. While Walgreens has not yet responded to requests for comment, the case has already sparked a broader conversation about the ethics of pharmaceutical pricing and the need for greater transparency in the healthcare system.
As this legal battle unfolds, it serves as a stark reminder of the real-world impact of healthcare policies and practices. The tragic loss of Cole Schmidtknecht underscores the urgent need for reforms that ensure essential medications remain accessible and affordable for all patients, regardless of their financial circumstances.
Sources:
- Wisconsin couple sues Walgreens and Optum Rx, saying son died after $500 price rise for asthma meds
- Wisconsin couple sues Walgreens and Optum Rx, saying son died after $500 price rise for asthma meds
