U.S. Sen. Ron Wyden, a Democrat representing Oregon, has some questions about the causes for a wave of pharmacy closures, most notably those in 56 Bi-Mart stores, including the stores in Baker City, La Grande, Pendleton and Hermiston.

The senator is right to ask those questions.

And although the answers he might get likely won’t resurrect any pharmacies, perhaps Wyden’s efforts can stave off future closures, particularly in rural areas such as Union County and Umatilla County, where residents have fewer options for filling prescriptions.

Wyden, who is chairman of the Senate Finance Committee, wrote a letter to Chiquita Brooks-LaSure, administrator of the Centers for Medicare and Medicaid Services, a federal agency. Wyden cited the Bi-Mart pharmacy closures, noting that pharmacies across Oregon have reported as a problem the “direct and indirect remuneration” fees imposed by Medicare Part D plans and pharmacy benefit managers — which Wyden describes as “middlemen.”

“I am deeply concerned that the rise of these fees has contributed to the permanent closure of 2,200 pharmacies nationwide between December 2017 and December 2020,” Wyden wrote in his letter to Brooks-LaSure.

The pharmacies are the casualty of a sale involving the Bi-Mart Corporation and Walgreens, one of the nation’s largest pharmacy chains. Walgreens, as part of the purchase agreement, will buy all of Bi-Mart’s pharmacies. Walgreens will operate many of Bi-Mart’s already existing pharmacies, but not at some stores, including Baker City and La Grande’s, according to Don Leber, Bi-Mart president of marketing and advertising.

Wyden also wrote these fees “can be deployed as anti-competitive tactics” by the pharmacy benefit managers — companies that manage prescription drug benefits on behalf of health insurers, Medicare Part D plans and large employers, among other clients.

Wyden is calling on the Centers for Medicare and Medicaid Services to review pharmacy closures in the U.S. over the past five years, including the nature and effect of PBM payment practices, and to use the agency’s authority to regulate their fees.

That’s a good start to addressing a problem that, if recent trends are any indication, might continue to worsen in the years ahead.