In early 2024, a devastating incident in Wisconsin placed the issue of rising drug costs at the center of national discussion, revealing the complex intersection of corporate policies, healthcare regulations, and their human consequences.
A Life-Saving Medication Becomes Unaffordable
On January 10, 2024, 22-year-old Cole Schmidtknecht, who had long managed his asthma with an affordable inhaler, was shocked to find its price had surged to $539.19 from the usual $66.86. His pharmacist informed him that his insurance no longer covered the medication, leaving him with no alternative. Unable to afford the new price, Cole left without his inhaler.
Days later, on January 15, Cole suffered a severe asthma attack. His roommate rushed him to the emergency room, but Cole became unresponsive and his heart stopped before arriving before arriving. Despite doctors’ efforts, he never regained consciousness. After six days on life support, his parents made the heartbreaking decision to let him go. He was pronounced dead on January 21.
In January, Cole William Schmidtknecht went to the pharmacy to refill his asthma medication, which he had taken for years. At the pharmacy, Cole found out that the Pharmacy Benefit Manager had increased the price of Cole’s steroid prescription from around $35 dollars to over $500… pic.twitter.com/4nLQClu6dM
— Rep. Jake Auchincloss 🟧 (@RepAuchincloss) December 6, 2024
The Legal Battle and Industry Practices
Cole’s parents have since filed a lawsuit, alleging that both the pharmacy and the pharmacy benefit manager (PBM) failed to notify him of the coverage change. The case highlights a troubling industry practice known as “non-medical switching,” where PBMs push patients toward more expensive medications based on financial agreements rather than medical necessity.
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