Family sues pharmacy, drug 'middleman' after price hike leads to son’s fatal asthma attack

Cole Schmidtknecht, 22, had insurance but couldn’t afford to refill his asthma inhaler after the cost jumped from $70 to more than $500 at his pharmacy.

When 22-year-old Cole Schmidtknecht tried to get a refill on the inhaler prescribed by his doctor to prevent asthma attacks, the medication that had formerly cost him less than $70 at his Appleton, Wisconsin pharmacy was now priced at more than $500, according to Cole’s father, Bil Schmidtknecht.

Stunned, Cole left the store with a medication designed to stop asthma attacks once they start, but without the Advair Diskus inhaler he needed to prevent attacks from happening in the first place.

Five days after his pharmacy visit last year, Cole had a severe asthma attack, stopped breathing and collapsed. He never regained consciousness and died. Doctors attributed his death to asthma.

Cole Schmidtknecht, left, his mother, Shanon, his brother, Dane, and father, Bil.Courtesy Schmidtknecht FamilyHis parents, Bil and Shanon Schmidtknecht, blame what they say is a dysfunctional system where medications can change in price overnight and without notice.

A part of the insurance system that many Americans don’t know about was responsible for the spike in Cole’s inhaler price. Pharmacy benefit managers, or PBMs, are the middlemen that control behind the scenes which drugs will be on an insurance company’s list of covered medications (called its formulary).