Local pharmacists look to Congress to help loosen Rx squeeze

Pharmacist Nasir Mahmood, Pine Plains Pharmacy, is advocating for independent community pharmacies to allow them to continue serving their communities.
Leila Hawken
Pharmacist Nasir Mahmood, Pine Plains Pharmacy, is advocating for independent community pharmacies to allow them to continue serving their communities.
Local pharmacies are historically central to community life and have been for generations. If they offered a soda fountain counter with round swivel stools, so much the better.
Today’s family pharmacists throughout the area, however, are struggling under an oppressive pharmaceutical insurance middleman system that strips away profit from their prescription counter.
Beginning in the 1960s, Pharmacy Benefits Managers (PBMs) came upon the scene to process drug claims for insurance companies. By the 1970s they were serving as middlemen between manufacturers, insurance companies and pharmacies, adjudicating prices.
Today, PBMs not only adjudicate claims, but now they develop and manage pharmacy networks, determine the list of drugs to be covered by insurance, set co-pay amounts and serve to channel the patient to a particular choice of pharmacy.
According to the Pharmacists Society of the State of New York (PSSNY), PBMs can own their own pharmacies, retail and mail order, and profit from sales and services. The work of the PSSNY is to propagate and protect community pharmacies.
The effect of this progression as PBMs have become “invisible middlemen” has been devastating to local family-owned pharmacies in area towns in New York and Connecticut, endangering their existence and the invaluable service they provide to their patients and the communities they serve.
Today, the three largest PBMs control nearly 80% of the prescription benefits market share in the U.S., according to the PSSNY.
“We are so lucky to have this pharmacy. It’s a blessing,” said Pine Plains resident Ann Noone, a regular customer of the Pine Plains Pharmacy, commenting on Monday, April 8 about the local business and its pharmacist. “He’s done a lot for this town.”
Pharmacist at the Pine Plains Pharmacy since 1989, and owner of the historic corner drug store since 2006, Nasir Mahmood has witnessed the financial squeeze on area pharmacies with some forced to close their doors, victims of the PBM system.
It is the PBMs that pre-determine how much each drug covered under the plan should cost, and this is the amount it reimburses all pharmacies except the large-chain ones they own. Often the reimbursement rates are well below the cost of the drug, putting pharmacies in the position of having to fill a prescription at a loss.
“We cannot wait for PBM reform,” said Mahmood on Wednesday, March 27, describing the current tenuous status of bi-partisan federal legislation awaiting vote in Washington, D.C.
Having served as president of the PSSNY for two years in 2008-09 and having finished a two-year term as chairman of the PSSNY Board in March, Mahmood now continues as a member of that board. He also serves on the National Legislative Committee within the National Community Pharmacists Association (NCPA) working with other pharmacists’ professional organizations promoting new legislation to place limits on PBMs and create an equitable structure of reform and accountability.
Bipartisan bills have passed out of committee and are awaiting floor vote that would provide strict regulation and transparency to the work of the PBMs, improve patient access and lower costs, Mahmood said. The NCPA has achieved some recent success in the long process of bringing bills to the floor for a vote.
A series of Senate and House bills received bipartisan support and convincing vote margins as they emerged from committees. With passage, the various pieces of legislation would bring lower drug costs, greater transparency in the process, require the Centers for Medicare and Medicaid Services (CMS) to define their contract terms, and require PBMs to operate with greater transparency.
The legislation was attached to the government funding package that was passed in late March to avoid a government shutdown, but Mahmood said that at the last minute the PBM bills were stripped out of the package.
Continuing their commitment to PBM reform, however, Senate Finance Committee Chairman Ron Wyden (D-OR) and Ranking Member Mike Crapo (R-ID) pledged to press on with efforts to enact the legislation before the end of this congressional year.
The NCPA further reported that on Friday, March 22, a bipartisan group of 21 senators and 51 house representatives signed a letter to their respective leadership, asking for immediate action on PBM reform measures.
Advocacy groups are actively pursuing passage of the legislation having arranged a conference drawing pharmacists from across the U.S. to the national headquarters of the NCPA in Alexandria, Virginia, for a two-day meeting to begin on Wednesday, April 17.
“We’ve come a long way with continued advocacy year after year,” Mahmood said, contemplating his participation in the upcoming meeting. Senators and representatives will be reporting to the conference and encouraging continued advocacy strategies to promote passage of the bipartisan PBM legislation.
One bill would bring transparency to Medicaid drug pricing with annual savings of $1 billion. Another would remove PBMs from negotiating CMS services, and the third would provide for greater transparency, oversight and enforcement through the Federal Trade Commission (FTC).
Independent pharmacies throughout the area have expressed their concern about the issue and joined in the hope that the current efforts toward passing legislation will be successful.
Meanwhile, local and area pharmacists remain in the balance, squeezed by the PBM system and locked out of the price negotiation process. During an interview, Mahmood noted that there is not one independent community pharmacy left open in Columbia County.
“It’s not fair,” he said.
Whenever I need to get a quick but scenic bicycle ride but don’t have time to organize a group ride that involves driving to a meeting point, I just turn right out of my driveway. That begins a 32-mile loop through some of the prettiest scenery in northern Litchfield County.
I ride south on Undermountain Road (Route 41 South) into Salisbury and turn right on Main Street (Route 44 West). If I’m meeting friends, we gather at the parking area on the west side of Salisbury Town Hall where parking is never a problem.
We make a left on Salmon Kill Road and begin the most beautiful five-mile section of the route through rolling hills and beautiful farm country spread out over the length of the scenic valley. Fortunately, the Salmon Kill Bridge has been reopened after a two-year reconstruction — its lengthy closure was a real bummer.
After a short climb and descent, Salmon Kill terminates at Lime Rock Road.
This is the busiest and least enjoyable section of the ride, but lasts only about a mile when we turn left at the Trinity Lime Rock Episcopal Church and follow Dugway Road, with its rolling hills along the south side of the Housatonic River.
We usually stop on the Falls River Bridge to check out the volume of water flowing over the Great Falls. We make a right off the bridge on to Water Street, pass the power plant and Appalachian Trail parking lot, and go under the railroad bridge with a sharp left up a steep but short hill north on Route 126 (Point of Rocks Road.)
Now we’re on a long, flat run that includes a slight right on Sand Road, which we follow all the way to Route 7 at the Canaan Country Club. A left here leaves you on a very busy state highway less than a mile before turning right onto Lower Road — be careful — but there’s plenty of shoulder.
Lower Road runs parallel to the Blackberry River and passes both modern and historic local industry: the impressive lime rock quarry operated by Specialty Minerals Inc., followed by the Beckley Iron Furnace State Park.
Next, we make a left on the appropriately named Furnace Road, across Route 44 — careful again — and face a steep but short climb up Allyndale Rd. Following it to the left begins a long stretch of beautiful farms and distant views of the Southfield and New Marlborough hills. We pick up a lot of speed downhill, zip past Sodom Road, and then a flat stretch to Clayton Road and into Massachusetts.
Continue straight (north) on Polikoff Road, then make a left onto Hewins Road if you want to keep the ride short. Alternatively, you could turn right on Hewins Road and follow it to Maple and into Sheffield to add another 5 to 10 miles.
But, if you’re sticking with the 32-mile ride, turn left on Hewins and take it across Route 7, followed by a left on Main Street and into Ashley Falls’ bucolic town center.
The right turn on Rannapo Road takes us along and across the winding Housatonic River ,where we watch the corn grow from seedlings to more than six feet by late summer.
Next is a left on to the daunting Cooper Hill Road — the steepest and only tough climb of the route. The effort is rewarded by spectacular 360-degree views, including the mountains of the Taconic Ridge and Appalachian Trail to the west.
A left onto Silver Road leads to the payoff: two steep descents, a view of the Twin Lakes on the left, and arrival at stately Taconic Road, home to some of Salisbury’s grandest old estates. A left on Taconic Road offers more rolling farm hills and beautiful views of the Taconic Ridge.
It terminates at Route 44, where we make a right (west) and let the long, steep descent carry us all the way into Salisbury, past the White Hart Inn and back to our starting point at Town Hall.
That’s the route: a relatively flat 1,500 feet of climbing with minimal car traffic. We usually reward ourselves with post-ride refreshments on the White Hart lawn.
I hope you enjoy this local gem of a ride!
Kent Hiteshew is a Salisbury cyclist.
This is a lovely ride that loops from Ancramdale north to Copake and back. At just over 23 miles and about 1,300 feet of elevation gain, it’s a perfect route for intermediate recreational riders and takes about two hours to complete. It’s entirely on quiet roads with little traffic, winding through rolling hills, open countryside, picturesque farms and several lakes.
Along the way, you’ll pass a couple of farmstands that are worth a quick visit. There is only one hill that might be described as steep, but it is quite short — probably less than a quarter-mile.
The ride starts and ends at The Farmer’s Wife Café in Ancramdale, a great place for lunch or refreshments after the ride. (The café is closed on Mondays and Tuesdays). Parking is usually available between the café and the Ancramdale post office. But be courteous — don’t monopolize parking needed by the café’s guests and staff!
Here are the coordinates for the ride:
Turn left out of the parking lot of the Farmer’s Wife onto County Road 8.
At .5 miles, turn left on Crest Lane
At 1.9 miles, turn left on East Ancram Road
At 6.8 miles, turn left on County Road 3
At 7.0 miles, turn right on Wiltsie Bridge Road
At 7.7 miles, turn right on Empire Road
At 10.7 miles, go straight through the village of Copake onto Main Street.
At 11.1 miles, bear left onto Farm Road
At 11.3 miles, turn left on Mountain View Road
At 12.1 miles turn right on County Road 7A
At 12.3 miles, turn left on Snyder Pond Road
At 13.0 miles turn left to stay on Snyder Pond Road
At 14.2 miles, turn right on County Road 7
At 14.8 miles turn left on County Road 27 (This is where there is short hill.)
At 15.5 miles, make a hairpin turn to the left on County Road 27A. (This can be easy to miss so be on the lookout for it).
At 17.5 miles, go straight across County Road 7 onto Four Corners Road.
At 18.7 miles, turn right on Wiltsie Bridge Road
At 19.0 miles, turn left on Snyder Road
At 20.3 miles, bear left onto Roche Drive
At 20.8 miles, turn right on County Road 3
Follow County Road 3 back to Ancramdale and the Farmer’s Wife.
Jeremy Koch is a Norfolk cyclist.
Aerial view of The Shed at Tanglewood in Lenox, Mass.
Now is the perfect time to plan ahead for symphonic music this summer at Tanglewood in Lenox, Massachusetts. Here are a few highlights from the classical programming.
Saturday, July 5: Shed Opening Night at 8 p.m. Andris Nelsons conducts the Boston Symphony Orchestra as Daniil Trifonov plays piano in an All-Rachmaninoff program. The Piano Concerto No. 3 was completed in 1909 and was written specifically to be debuted in the composer’s American tour, at another time of unrest and upheaval in Russia. Trifonev is well-equipped to take on what is considered among the most technically difficult piano pieces. This program also includes Symphonic Dances, a work encapsulating many ideas and much nostalgia.
On Sunday, July 6 at 2:30 p.m., the next master pianist, Yefim Bronfman, joins Andris Nelsons as he conducts the BSO in the Shed. Bronfman features in an All-Beethoven program. Hear the Leonore Overture No. 2 followed by the Piano Concerto No. 3, a deeply expressive work that highlights the lively interplay between the BSO strings, winds, and Bronfman’s piano. After intermission, experience the epic Symphony No. 5.
On Saturday, July 12 at 8 p.m. in the Shed, the Boston Symphony Orchestra and Andris Nelsons join pianist Seong-Jin Cho in celebrating the 150th birth year of Maurice Ravel. Expressive, sincere, and wonderful, Cho’s playing is bound to create a rich evening of music that includes “Prelude to The Afternoon of a Faun” (Debussy), “Piano Concerto in G” (Ravel), “Piano Concerto for the Left Hand” (Ravel), and “La Mer” (Debussy).
On Sunday, July 13 at 2:30 p.m. in the Shed, the Boston Symphony Orchestra and Finnish conductor Esa-Pekka Salonen will be a superb combination, along with the energetic young Finnish violinist Pekka Kuusisto. Kuusisto comes from distinguished musical lineage, and he’s equally captivating whether performing classical works or masterfully weaving Northern European folk melodies. The program includes “Tumblebird Contrails” (Gabriella Smith), “Violin Concerto” (Sibelius), and “Symphony No. 5” (Sibelius).
On Saturday, July 19 at 8 p.m. in the Shed, the Boston Symphony Orchestra and Andris Nelsons present the Piccini’s “Tosca,” with special guest singers Kristine Opolais, Seok Jong Baek, Bryn Terfel, Patrick Carfizzi and the entire Tanglewood Festival Chorus, with James Burton conducting. Expect an unforgettable evening in the Shed, with beauty and brilliance at full volume—star power layered on star power.
Beginning Thursday, July 24 at 8 p.m. in Ozawa Hall, the TMC Festival of Contemporary Music kicks off with Ortiz and the Mexican Tradition. This year’s festival runs through Monday, July 28 and features music of Mexican music educator and composer Gabriela Ortiz Torres, Carnegie Hall’s composer in residence for the 2025 season. This superb Festival within a Festival is a proverbial “Box of Chocolates”, where you never quite know what flavor is in the middle until you bite.
On Friday, July 25at 8 p.m. in the Shed, the Boston Symphony Orchestra and Andris Nelsons welcome Spanish-born violinist María Dueñas. At a mere 18 years old, Dueñas has already won the 2021 Menuhin Competition, including the audience award. The BBC also named her as its “New Generation Artist 2021-2023.” This program includes “Air,” from Orchestral Suite No. 3 (J.S. Bach), and “Adagio from Symphony No. 10” (Mahler) before Mendelssohn’s “Violin Concerto”,“Calm Sea”, and “Prosperous Voyage.”
On Sunday, July 27 at 2:30 p.m. in the Shed, the Boston Symphony Orchestra and Andris Nelsons welcome pianist Lang Lang.Lang Lang is squarely in the 100% not to be missed category, and this afternoon the audience will be indulged with “La Calaca” (Gabriela Ortiz) for string orchestra, Piano Concerto No. 2 (Saint-Saëna), and Beethoven’s “Symphony No. 6, Pastoral.”
On Saturday, August 16 at 8 p.m. in the Shed, the Boston Symphony Orchestra join with German conductor and concert pianist Anna Handler and young Italian-German-American violinist Augustin Hadelich to present the Brahms’s “Tragic Overture,” “Symphony No. 4” (Schumann), andTchaikovsky’s Violin Concerto. The constellation this evening looks to become especially bright, colorful, and passionate. Plan to come early and stay late.
On Sunday, August 17 at 2:30 p.m. in the Shed, the Boston Symphony Orchestra welcomes conductor Dima Slobodeniouk, who was born in Moscow and settled in Finland.Pianist Jean-Yves Thibaudet is another musician not to miss; every appearance is fresh and lively. This program includes “Threnody (In Memory of Jan Sibelius)” by William Grant Still, “Piano Concerto No. 2” (Liszt), “Valse triste” (Sibelius), and “Symphony No. 3.” (Sibelius).
The 2025 Tanglewood season promises to be another exciting one. A quick note: the BSO has faced issues with ticket resellers posing as official sources and charging inflated prices. To avoid this, be sure to purchase tickets in advance only through bso.org.
SHARON — James H. Fox, resident of Sharon, passed away on May 30, 2025, at Vassar Brothers Hospital.
Born in New York, New York, to Herbert Fox and Margaret Moser, James grew up in Hastings-on-Hudson, New York. He spent his summers in Gaylordsville, Connecticut, where he developed a deep connection to the community.
James attended Millbrook School, Ripon College, and the Culinary Institute of America in New Haven, Connecticut.
He proudly served in the Navy and his dedication to his craft led him to later own several restaurants, including the renowned Fox & Fox in Gaylordsville, and most recently, Panini Cafe in Kent. He went on to become a staple at the Cornwall Farmer’s Market, known for his delicious soups.
James lived in Sharon, for 20 years, where he cherished the serenity tending to the gardens and property. Perpetually in motion, he filled his days with gardening, tending his property, and engaging in hobbies such as collecting model cars, woodworking, and perfecting his culinary creations.He never hesitated to take on a new project, no matter the scope.Not many 82-year-olds can say they fully remodeled a bathroom single handedly.After a full day of work, one of his greatest joys was relaxing at the end of the day in front of the fireplace.
James is survived by his constant companion of 22 years, Kathie Dolan; his two sons; Adam Fox of Montpelier, Vermont and Emmett Fox of Bethlehem, Pennsylvania; his brother, Tom Fox of Phoenix, Arizona; his brother-in-law, Gary Sarachan of St. Louis; and several nieces, including Sydney Fox Sarachan of St. Louis, Carrie Fox of Phoenix, and Amanda Fox of Columbus, Ohio. He also leaves behind his grandson, Aidan Fox of New Hampshire, extended family, Erin Dolan, Megan Mollica, Rory Dolan, his dog, Django, and his cat, William.
James will be deeply missed by all who knew him. His unique sense of humor and culinary excellence will live on in the hearts of his family and friends.
The Kenny Funeral Home has care of arrangements.
All services are private.