A Wisconsin couple has filed a federal lawsuit against Walgreens and OptumRx, a subsidiary of UnitedHealth Group, claiming that their son’s death was caused by a sudden $500 increase in the price of his asthma medication, which he could not afford.
Family Seeks Justice and Reform After Tragic Loss
The lawsuit, filed in the U.S. District Court for the Eastern District of Wisconsin, demands financial compensation for damages, including the pain and suffering 22-year-old Cole Schmidtknecht endured before his passing in 2024. His parents, Bil and Shanon Schmidtknecht are not only seeking justice but also aiming to reform what they see as a flawed healthcare system.
“Our primary goal is to obtain justice for the Schmidtknecht family, who suffered an unimaginable loss,” said Helen Lawless, one of the attorneys representing the family.
The lawsuit claims that both Walgreens and OptumRx played a role in preventing Cole from obtaining the medication he had relied on for years.
What Happened to Cole Schmidtknecht?
Cole had been taking an inhaler daily since the age of 13 to manage his asthma. On January 10, 2024, he visited a Walgreens pharmacy in Appleton, Wisconsin, to refill his prescription. However, he was informed that his insurance no longer covered the medication, and the new out-of-pocket cost was $539.19—far more than he could afford.
With only a $5 copay rescue inhaler, Cole left the pharmacy without his daily medication. Five days later, he suffered a severe asthma attack. His roommate rushed him to ThedaCare Regional Medical Center, but by the time he arrived, he had no pulse. Despite medical efforts, Cole never regained consciousness and died on January 21, 2024.
Walgreens and OptumRx Respond
Walgreens declined to comment on the lawsuit, citing ongoing litigation. OptumRx released a statement expressing sympathy for Cole’s family but defended its formulary management, claiming it followed industry practices.
The Lawsuit’s Allegations Against Pharmacy Benefit Managers
OptumRx operates as a pharmacy benefit manager (PBM), negotiating drug prices between insurance companies and pharmacies. According to the lawsuit, PBMs wield significant influence over medication pricing and access, often prioritizing profits over patients’ needs.
The lawsuit alleges that OptumRx removed Cole’s inhaler, Advair Diskus, and its generic versions from its 2024 insurance coverage list, favouring newer, more expensive brands that offered financial incentives to OptumRx. Furthermore, Cole was never given the legally required 30-day notice about the change, leaving him with no time to request an exception from his doctor.
Additionally, the lawsuit claims that Walgreens failed to take the necessary steps to help Cole obtain his medication, such as notifying his doctor or recommending alternatives. The complaint suggests that Walgreens’ understaffing and lack of proper training contributed to Cole’s inability to secure his life-saving inhaler.
The Growing Influence of PBMs in the U.S. Healthcare System
PBMs play a dominant role in the U.S. prescription drug market. The three largest—CVS Caremark, Express Scripts, and OptumRx—processed nearly 80% of the 6.6 billion prescriptions filled in 2023. The Federal Trade Commission has warned that these entities have excessive control over medication prices and access, often resulting in inflated costs for consumers.
A 2024 FTC report highlighted that nearly 30% of Americans have skipped or altered their prescribed medication due to cost barriers. The Schmidtknechts lawsuit calls PBMs an “oligopoly” that dictates medication access based on financial motives rather than medical necessity.
Nationwide Push for Healthcare Reform
Cole’s tragic death has fueled calls for policy changes. His parents have since appeared on media outlets such as ABC News and “Good Morning America” to advocate for PBM reform.
In December 2024, Rep. Jake Auchincloss referenced Cole’s story in a congressional hearing while supporting the “Pharmacists Fight Back Act,” a bipartisan bill aimed at preventing PBMs from price-gouging essential medications. Although the bill did not pass, the fight continues.
Following public outcry, the manufacturer of Cole’s inhaler announced a $35 monthly price cap. This move came after lawmakers, including Senator Tammy Baldwin, investigated excessive inhaler pricing.
A Family’s Determination to Create Change
Despite their immense grief, Bil and Shanon Schmidtknecht remain committed to making a difference.
“The drive that Shanon and I have to continue to try to get justice for him and make sure this doesn’t happen again is just coming right out of Cole,” Bil said. “He always stood up for the little guys.”
As they push for reform, the Schmidtknechts remember Cole not just as a victim of a broken system but as a compassionate, intelligent young man who loved gaming, music, and movies. His friends described him as someone you could talk to for hours, full of curiosity and kindness.
Through their lawsuit and advocacy, his family hopes to honour his legacy by ensuring no other family has to suffer the same devastating loss.
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