In Part One of this advocacy series, we shared the heartbreaking story of Cole Schmidtknecht, a young Wisconsin man whose life was tragically cut short. Not because treatment did not exist, but because he could no longer afford it. Cole’s experience, while tragically not isolated, has strongly resonated and renewed urgency for change.
At WSPC, we are dedicated to amplifying the voices of independent pharmacies and the patients they serve. We support Cole’s Act and its mission to reform pharmacy benefit manager (PBM) practices. By sharing Cole’s story and raising awareness about the legislation introduced in his name, we emphasize the urgent need for PBM reform and inspire others to take action.
PBM reform is not about eliminating these entities altogether. It is about ensuring they operate transparently, ethically, and in a way that prioritizes
patient care. Unregulated PBM practices continue to harm patients, inflate prescription costs, and close community pharmacies.
What Is Cole’s Act?
Introduced in March 2025 by Wisconsin lawmakers, Cole’s Act is a bipartisan bill designed to directly address the issues within the prescription drug supply chain that contributed to Cole’s death.
At its core, the Act targets the unchecked influence of PBMs, which control nearly every aspect of the prescription process, from drug coverage decisions to pharmacy reimbursement rates. This legislation builds on the momentum of PBM reform efforts in other states and is part of a growing trend in which lawmakers recognize the urgent need to address PBM abuse.
Cole’s Act includes critical reforms such as:
- Prohibiting patient steering, which PBMs use to direct patients away from their trusted local pharmacies and toward PBM-owned mail-order services.
- Banning spread pricing, a tactic where PBMs reimburse pharmacies less than they charge insurers, profiting from the difference.
- Increasing transparency, requiring PBMs to disclose hidden fees, rebates, and pricing structures.
- Ensuring fair and timely reimbursement for pharmacies, so they can continue serving their communities sustainably.
“What’s going to be different this time is there’s national attention on PBM reform,” said Bil Schmidtknecht, Cole’s father. (WBAY)
In March, pharmacists, patients, and Cole’s family gathered at a press conference at the Wisconsin State Capitol, demanding real and lasting change. Their voices joined a growing national movement calling for transparency and fairness in a system that has long operated in the shadows. Cole’s story and his family’s courage have turned grief into purpose. This legislation is more than a policy proposal, it is a call to action, a stand for patients, and a vital step toward a healthcare system.
From Outcry to Action
States like Alabama, Arkansas, and Massachusetts have already taken bold steps to pass PBM reform legislation. Now, Wisconsin joins this growing list. These legislative wins are often long overdue, but they represent a clear trend: lawmakers are listening.
More importantly, patients and pharmacists are speaking up. Cole’s story is a painful reminder of the real-world consequences of unregulated PBM practices, yet his legacy is now driving meaningful change. His name stands for a movement that demands transparency, access, and patient-centered care.
Independent Pharmacies Are Not Alone
WSPC is dedicated to advocating for legislation that restores balance to the prescription drug system. Independent pharmacies are essential to our communities, and we cannot afford to lose more of them to the harmful tactics of PBMs. Every bill that passes brings us closer to ensuring that we can continue providing the care your patients need and deserve.
We encourage pharmacy professionals, patients, and advocates to stay engaged.
- Support legislation like Cole’s Act.
- Share your stories.
- Contact your lawmakers.
Your voice is powerful and necessary. We are not only defending independent pharmacies; we are protecting lives.
What You Can Do to Help
The National Community Pharmacists Association (NCPA) offers resources to support PBM reform efforts:
- PBM Reform Advocacy: Detailed information on PBM practices, state-level legislative tracking, and key issues surrounding PBM reform. NCPA
- Pharmacy Benefit Manager Legislation Materials: This collection includes infographics, background materials, and one-pagers that explain complex PBM issues, aiding in advocacy and education. NCPA
- Finish the Fight Campaign: NCPA’s initiative to mobilize pharmacists and patients in advocating for fair pharmacy reimbursement and PBM reform. The campaign offers printable assets, videos, and guidance on engaging with legislators. NCPA
- Legislative Action Center: A platform to stay informed about proposed legislation affecting independent pharmacies and to take action by contacting lawmakers. NCPA
Make your voice heard on Capitol Hill! Join the NCPA Congressional Pharmacy Fly-In to advocate for policies that protect patient care and ensure PBMs are held accountable. Register by April 21, 2025, at 11:59 PM ET.
Learn more and register today: NCPA Congressional Pharmacy Fly-in
