How Real Patient Experiences Have Helped Bolster Advocacy for PBM Reform

In January of 2024, Bil Schmidtknecht’s son, Cole, entered a community retail pharmacy to learn that his asthma medication was no longer covered by insurance. Avoiding the $500-plus copay on his medication, Cole could not afford it and later experienced an asthma attack, leading to his eventual death 6 days later.

“It became my life mission to get justice for my son, Cole, and making sure no one else dies,” Schmidtknecht, who’s the founder of Patient Protector and director of patient experience at AffirmedRx, told Drug Topics. “I quit my job, started a patient protector organization, called Patient Protector. [A local pharmacist] and some various staff members got involved with us—all volunteer, nonprofit, grassroots, no pharma money, nothing.”

After his son’s tragic passing, Schmidtknecht began researching pharmacy benefit managers (PBMs) and just how complex prescription drug benefits in the US can be. Learning of PBM tactics like prior authorization and the step process that led to his son losing insurance coverage, Schmidtknecht has since dedicated his life to PBM reform and making the health care system in America more geared toward patients’ needs.

“I've worked in Illinois, Texas, Oregon, Missouri, all kinds of states. We touch about almost 10,000 pharmacies with our social media, our docu-series The Modern Medical Mafia,” he continued. “We make it easy for a pharmacist to fight [for] PBM reform, if you want to say. It's just been a whirlwind.”

Stay tuned for weekly podcast episodes on Over the Counter every Thursday afternoon. Check out our previous episode with Joey Mattingly, PharmD, MBA, PhD, who discussed the unique trends in pharmacy turnover for independent and chain locations. He highlighted how these trends paint a bigger picture of the current retail pharmacy landscape.

Are you ready to elevate your pharmacy practice? Sign up today for our free Drug Topics newsletter and get the latest drug information, industry trends, and patient care tips, straight to your inbox.