U.S. Sen. Ron Wyden, D-Oregon, waged his ongoing battle with Big Pharma on local turf Wednesday in an effort to drive home the need to bring down drug prices.

“Our small pharmacies are facing unprecedented challenges,” Wyden said Wednesday at Ashland Drug, a small operation that serves many Medicare retirees. “They’re having trouble keeping the doors open.”

Across Oregon pharmacies are closing, hitting rural counties the hardest, and many have already shut their doors, including at Bi-Mart.

Wyden, who is also championing a bill that would bring down the cost of prescription drugs, said pharmacies are being squeezed by insurance and middlemen known as pharmacy benefit mangers who have jacked up fees by 91,000% in recent years.

Chris Hernandez, owner of Ashland Drug, said he often doesn’t even know what the current fee schedule is until months after sales are made, making it difficult to budget.

“We’re getting fees on top of ever-shrinking reimbursements,” he said.

Wyden said he plans to use legislation already on the books to make sure the pharmacy knows what the fees are at the point of sale, rather than getting stuck with a big bill months later.

He blasted a move by insurance and middlemen known as pharmacy benefit managers to create what he called an anti-free enterprise environment.

“There’s no way a small pharmacy can absorb all those fees,” Wyden said.

On another front, Wyden and other senators have been inching forward with legislation that could put a $2,000 annual cap on the cost of medications for seniors.

In some cases, seniors can’t afford a particular medication. Some of the more expensive drugs provide treatment for cancer and other severe illnesses.

Wyden said the bill would have an anti-price gouging provision along with an inflation cap on price increases for medications.

According to an analysis by the Kaiser Foundation, half the drugs on the market exceeded the inflation rate in a given year, Wyden said.

Insulin would have a $35 a month cap under the proposal.

Medicare would also gain the tools needed to negotiate the cost of medicines, something Wyden said could also help those with private insurance.

The much-debated proposed legislation currently only authorizes Medicare to negotiate the price of 20 drugs a year. A previous version that would have allowed negotiations of up to 250 drugs a year was shelved in order to reach a compromise with key senators.

Wyden said he would like Medicare to start with the most expensive drugs on the list.

While the legislation doesn’t offer everything Wyden wants, he said it would provide for some real changes that would help people dealing with the high cost of drugs.

“As you know, Big Pharma is going to fight this like no tomorrow,” he said.

Wyden rejected the idea that the changes would inhibit the ability of the pharmaceutical companies to create new drugs, pointing out that the government already provides a lot of the research dollars for these efforts.

He put considerable blame on a network of “unchecked” middlemen who set fees and hurt pharmacies in order to sustain the tremendous profits of the pharmaceutical companies.

Wyden said he thinks that most Oregonians would support the effort to bring down drug prices and help their local drug store stay open.

“We’re helping the people getting mugged at the pharmacy counters,” he said.

Many seniors on Medicare already are faced with the choice of buying an expensive medication or putting food on their table.

“Reducing the cost of medications for seniors is a matter of life or death,” said Sandy Theis, who is on the Ashland Senior Advisory Board. “They’re not taking the medication at all because of the cost.”

Reach freelance writer Damian Mann at dmannnews@gmail.com.