Death of Wisconsin Man Prompts Scrutiny of Pharmacy Benefit Manager Formulary Practices

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Death of Wisconsin Man Prompts Scrutiny of Pharmacy Benefit Manager Formulary Practices

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Washington Examinerjumped from under $70 to over $500, severe asthma attack

Buchanan Ingersoll & Rooney PC

Cole Schmidtknecht, 22, died on January 21, 2024, after a severe asthma attack and cardiac arrest. His family alleges that a formulary change by a pharmacy benefit manager rendered his Advair Diskus inhaler unaffordable. Industry data show three PBMs handling the majority of U.S. prescription claims.

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[Washington Examiner 👤] We have to accelerate pharmacy benefit manager reform right now. Here’s why [Buchanan Ingersoll & Rooney PC] A Pivotal Moment for Patients and Independent Pharmacies: Congress Acts on PBM Reform with Bipartisan Legislation

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Left

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Center

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Right

“We have to accelerate pharmacy benefit manager reform right now. Here’s why”

Read at Washington Examiner →

How different viewpoints frame this

Progressive

The case shows how three vertically integrated PBMs can abruptly restrict access to essential medications through formulary changes.

“Concentrated corporate power prioritizes profits over patient access and requires transparency and delinking reforms.”

Conservative

Oligopoly control by PBMs tied to insurers produces predictable access barriers that competition and ownership separation would address.

“Cronyist consolidation, not markets, creates the distortions; reform should target transparency and spread pricing.”

Libertarian

Regulatory barriers and opaque third-party systems empower a handful of middlemen to limit individual choice and inflate costs.

“Mandate price transparency and allow bypass of networks rather than new federal rules.”

Devil's Advocate

All views accept the unverified causal narrative from a single source without checking adherence history or alternative coverage.

“Upstream manufacturer pricing, clinical variables, and plan design details remain unexamined.”

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