As prescription drug costs rise, both legislators and small-town Minnesota communities are asking how it happened, and more importantly, what’s to be done about it.

Members of Sen. Amy Klobuchar’s staff made a stop in Northfield on Thursday as part of a statewide series of discussions on the cost of prescription drugs, an issue that has emerged as one of the senator’s top priorities. Local health care providers and community members turned out to the event, held at FiftyNorth, to ask questions and share concerns with Elizabeth Ebot, a senior adviser to Klobuchar, and Ibad Jafri, constituent advocate.

Through a prerecorded video introduction, Klobuchar told of her personal connection to the issue through the story of her daughter, who needed a lifesaving epinephrine dose as a toddler and from then on carried an EpiPen — while prices tripled over the course of only a few years.

More recently, Klobuchar brought the issue into the public eye by inviting Nicole Smith-Holt — whose diabetic son died after being unable to afford a $1,300 insulin refill — as her guest to the State of the Union address.

Klobuchar has recently introduced a number of bills to fight these increasing drug costs, including a bill that would allow Medicare to negotiate with pharmaceutical manufacturers; one that would enable Americans to import a 90-day supply of medication from Canada; and a ban on “pay for delay,” where name-brand drug manufacturers pay off companies to reduce competition from inexpensive generic drugs.

“If there’s ever a time to get this legislation passed, it is now,” said Ebot.

Dave Miller, a retired pharmacist, has watched the shifting relationship between pharmacists and drug companies for over 45 years. It was a simpler partnership, he said, until involvement from insurance companies drove prices up.

“The pricing schemes have become so complicated, convoluted and hidden that nobody, including the people who are contracting for drug services, can understand it,” said Miller.

The call for transparency in pharmaceutical costs was echoed around the table — and across the state, according to Ebot, with insulin, inhalers and chronic obstructive pulmonary disease medication consistently listed as top concerns.

Another issue raised at every single stop of the two-day tour was direct-to-consumer drug marketing, said Ebot, and Northfield was no exception. One attendee suggested banning any advertising of medication on television, arguing that it undermines the relationship between physicians and patients. And since advertising has its own costs, it can drive up the prices passed on to consumers.

“It’s evident that we’re struggling to maintain relationships between patients and physicians,” said Jafri.

Miller expressed discomfort with the idea of solving every issue through legislation, but agreed that “something’s got to be done.” Allowing Americans to access Canadian drugs, in his view, was a “Band-Aid” approach to the issue.

While legislation was a big part of the conversation, others pointed to solutions like CivicaRx, a nonprofit generic drug company launched in 2018 by Mayo Clinic, among others. By producing their own generic versions of prescription drugs, member hospitals aim to prevent medication shortages and lighten patient costs.

“It’s the idea of removing the profit out of the pharmaceutical model,” said Ebot.

Klobuchar’s legislation has yet to pass, but her staff noted that her three major health care bills have made their way to the appropriate Senate committees.

“The conversation has shifted so much, in a bipartisan way, that we’re optimistic about getting these passed this session,” said Jafri.