A complaint alleges that a young man died after the price of an inhaler skyrocketed from $66 to $539

A young man from Wisconsin with a bright future, Cole had been afflicted with chronic asthma since birth, according to The Kansas City Star. Despite his impairment, he was able to lead a full life by taking daily dosages of the preventative inhaler Advair Diskus.

For many years, Cole’s insurance covered his affordable prescription medications. He was shocked to learn that his life-saving medicine was no longer covered when he went to Walgreens in January 2024. The revised price is $539.

Like he always did, Cole went to his local Walgreens on January 10, 2024, to get his prescription filled. But after learning that Advair Diskus was no longer covered by his insurance, he decided not to pay the usual $66.

According to reports, the pharmacist told him that there were no generics or less costly alternatives available and failed to contact his doctor or insurance company to find a solution.

Cole left the pharmacy without his prescription, unhappy and devastated. Over the next two days, he managed his breathing with an old emergency inhaler. Five days later, terrible things happened. Cole had a terrible asthma attack and was unable to breathe. While being carried to the medical hospital by his roommate, he passed out.

The medics did their best to revive Cole, but he never came back to consciousness. After six days, his parents took the difficult decision to remove him from life support. Cole’s death was formally announced on January 21, 2024.

 

Cole’s upset parents have since filed lawsuits against Walgreens and OptumRx, the pharmaceutical plan manager, alleging that they prioritize profits over patients. A Walgreens spokeswoman told HuffPost that they couldn’t comment due to the current legal processes.

The lawsuit claims that in 2024, OptumRx modified its formulary, requiring prior authorization from a physician for patients taking Advair Diskus or a generic version of the medication. But according to the lawsuit, Walgreens and Cole’s insurer failed to notify him that his prescription would no longer be covered, which is a flagrant violation of state law.

“The evidence in this case will demonstrate that Cole’s death was directly caused by OptumRx and Walgreens, who prioritised profits,” said Michael Trunk, the family’s attorney, without holding back.

The lawsuit also alleges that OptumRx engaged in “non-medical switching,” a practice wherein pharmacy benefit managers coerce patients into taking more expensive medications in exchange for kickbacks from manufacturers. According to reports, OptumRx only provided coverage for Cole’s two more recent brand-name drugs, whose manufacturers allegedly paid hefty rebates to secure favorable formulary placement.

Cole’s horrific story has sparked outrage and calls for reform. Representative Jake Auchincloss of Massachusetts honored Cole during a congressional hearing in December and asked lawmakers to pass the Pharmacists Fight Back Act. The purpose of the proposed law is to prevent price-gouging by pharmaceutical benefit managers and to prevent future occurrences of circumstances similar to Cole’s.

Cole’s family is personally affected by the dispute. They want justice for their child and hope that his story will bring attention to the awful consequences of a broken healthcare system. “We hope that this lawsuit and Cole’s death will lead them to kind of reflect on their own policies and change their policies going forward,” Schmidtknecht’s family attorney told WMTV. We have to make sure Cole’s story is heard. Share this article to start a conversation and increase awareness of the problems facing our healthcare system.

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