Inhaler Price Surge Contributed to Young Man's Death: Lessons for Healthcare Providers

The Tragic Case of Cole Schmidtknecht: A Wake-Up Call for Healthcare

The story of 22-year-old Cole Schmidtknecht, who tragically died from an asthma attack after being unable to afford his inhaler, is a stark reminder of the healthcare system's failures. Just days before his passing, Cole learned that the price of his regular Advair Diskus inhaler had soared by an astonishing 700%, going from under $70 to over $500. This drastic spike forced him to leave the pharmacy empty-handed, illustrating a painful truth for many patients who rely on necessary medications.

Understanding Pharmacy Benefit Managers (PBMs)

The sudden increase in Cole's inhaler price highlights the pivotal yet often opaque role of Pharmacy Benefit Managers (PBMs) in the healthcare system. These entities negotiate drug prices and manage formularies for insurers. Cole's family has sued Optum Rx, the PBM responsible for removing the inhaler from its formulary without proper notification. Critics argue that such practices lure patients into a system designed to profit at their expense, rather than prioritizing their health outcomes.

The Emotional Toll of Inaccessible Medication

This heartbreaking incident has affected not just Cole's family but has prompted a wider conversation about the human cost of unaffordable medication. His mother, Shanon Schmidtknecht, states, “Justice for Cole, of course, but bigger than that, justice for us all.” This highlights not only their personal grief but also reflects a call to action for systemic change in the healthcare industry.

A Broader Perspective on Prescription Drug Pricing

The Schmidtknecht case is just one example of a growing trend where dramatic price increases for essential medications are leading to tragic outcomes. Recent FTC reports indicate that major PBMs like CVS Caremark and Express Scripts have also raised costs for life-saving medications significantly, adding fuel to a fire of public outrage over pharmaceutical pricing.

Legislative Response and Future Implications

In response to Cole's death, his parents are advocating for legislation that requires PBMs to give patients at least 90 days' notice before dropping essential medications from insurance coverage. This represents an important step in protecting patients from unexpected costs that can lead to dire consequences. Advocating for transparency and patient-centered policies is crucial in reshaping how health care operates.

Building Connections in Concierge Medicine

For practitioners in concierge medicine, this situation underscores the importance of empathetic engagement with patients. Concierge practices have a unique opportunity to foster deeper connections with patients, prioritizing their whole health, including addressing the social determinants that can affect treatment access. Patients who feel heard and supported are more likely to successfully manage their medications and treatment plans.

The Need for Continued Advocacy in Healthcare

The ongoing battle against high medication prices requires collective action and advocacy. Families like the Schmidtknechts remind us that the lives lost to preventable issues should motivate all healthcare practitioners to take a stand against unjust pricing policies and work toward ensuring fair access to essential medications. For those involved in concierge practices, this advocacy can also be a differentiating factor in securing a position as a trusted care provider in your community.

In light of these concerns and the advocacy from affected families, healthcare providers must position themselves as allies in improving patient access and medication affordability. By prioritizing compassionate care and challenging the status quo in healthcare pricing, practitioners can truly embody the essence of patient-centered care.