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.
SHARON — Sharon Dennis Rosen, 83, died on Aug. 8, 2025, in New York City.
Born and raised in Sharon, Connecticut, she grew up on her parents’ farm and attended Sharon Center School and Housatonic Valley Regional High School. She went on to study at Skidmore College before moving to New York City, where she married Dr. Harvey Rosen and together they raised two children.
Sharon’s lifelong love of learning and the arts shaped both her work and her passions. For decades, she served as a tour guide at the American Museum of Natural History and the Asia Society, sharing her knowledge and enthusiasm with countless visitors. She also delighted in traveling widely, immersing herself in other cultures, and especially treasured time spent visiting her daughter and grandsons in Europe and Africa.
She was also deeply connected to her hometown, where in retirement she spent half her time and had many friends. She served as President of the Sharon East Side Cemetery until the time of her death, where generations of her family are buried and where she will also be laid to rest.
She is survived by her husband, Harvey; her children, Jennifer and Marc; and four beloved grandchildren.
Claire and Garland Jeffreys in the film “The King of In Between.”
There is a scene in “The King of In Between,” a documentary about musician Garland Jeffreys, that shows his name as the answer to a question on the TV show “Jeopardy!”
“This moment was the film in a nutshell,” said Claire Jeffreys, the film’s producer and director, and Garland’s wife of 40 years. “Nobody knows the answer,” she continued. “So, you’re cool enough to be a Jeopardy question, but you’re still obscure enough that not one of the contestants even had a glimmer of the answer.”
Garland Jeffreys never quite became a household name, but he carved out a singular place in American music by refusing to fit neatly into any category. A biracial New Yorker blending rock, reggae, soul and R&B, he used genre fusion as a kind of rebellion — against industry pigeonholes, racial boundaries and the musical status quo. Albums like “Ghost Writer” (1977) captured the tension of a post–civil rights America, while songs like “Wild in the Streets” made him an underground prophet of urban unrest. He moved alongside artists like Lou Reed and Bruce Springsteen but always in his own lane — part poet, part agitator, part bridge between cultures.
“I think what I tried to do with the film, wittingly or unwittingly, was just to show that we all have these lives and they don’t often meet our dreams of what we think we’re entitled to, we’re talented enough to get or whatever,” said Claire. “We all have these goals, but we’re sort of stymied. Often, it’s partly circumstance and luck, but it’s also very often something that we’re doing or not doing that’s impeding us.”
This is not the typical rock-and-roll redemption story. There are no smashed guitars, no heroic overdoses, no dramatic comeback tour. What we get instead is something quieter and more intimate: hours of archival footage that Claire spent years sorting through. The sheer effort behind the film is palpable — so much so that, as she admitted with a laugh, it cured her of any future ambitions in filmmaking.
“What I learned with this project was A, I’m never doing it again. It was just so hard. And B, you know, you can do anything if you collaborate with people that know what they’re doing.”
Claire worked with the editing team of Evan M. Johnson and Ben Sozanski and a slew of talented producers, and ended up with a truthful portrayal — a beautiful living document for Garland’s legions of fans and, perhaps most importantly, for the couple’s daughter, Savannah.
“She’s been in the audience with me maybe three or four times,” said Claire. “The last time, I could tell that she was beginning to feel very proud of the effort that went into it and also of being a part of it.”
Savannah pursued a career in music for a while herself but has changed tracks and become a video producer.
“I think she couldn’t quite see music happening for herself,” said Claire. “She was like, ‘I don’t know if I want to struggle the way I saw my dad struggling and I’m going to get a job with a salary.’”
The film doesn’t just track the arc of an underappreciated musician, however. The music, always playing, is the soundtrack of a life — of a man navigating racial, musical and personal boundaries while balancing marriage, parenthood, aging, addiction andrecovery. Garland and Claire speak plainly about getting sober in the film, a life choice that gave them both clarity and shows Claire as a co-conspirator in his survival.
“I did some work early on with a director,” said Claire. “He wanted the final cut, and I didn’t feel like I could do that — not because I wanted so much to control the story, but I didn’t want the story to be about Alzheimer’s.”
Diagnosed in 2017, Garland, now 81, is in the late stages of the disease. Claire serves as his primary caregiver. The film quietly acknowledges his diagnosis, but it doesn’t dwell — a restraint that feels intentional. Garland spent a career refusing to be reduced: not to one sound, one race or one scene. And so the documentary grants him that same dignity in aging. His memory may be slipping, but the film resists easy sentimentality. Instead, it shows what remains — his humor, his voice, his marriage, the echo of a life lived on the edges of fame and at the center of his own convictions.
The Moviehouse in Millerton will be screening “The King of In Between” on Sept. 20 at 7 p.m. Peter Aaron, arts editor of Chronogram Magazine will conduct a talkback and Q&A with Claire Jeffreys after the film. Purchase tickets at themoviehouse.net.
The Haystack Book Festival, a program of the Norfolk Hub, brings renowned writers and thinkers to Norfolk for conversation. Celebrating its fifth season this fall, the festival will gather 18 writers for discussions at the Norfolk Library on Sept. 20 and Oct. 3 through 5.
Jerome A. Cohen, author of the memoir “Eastward, Westward: A Lifein Law.”Haystack Book Festival
For example, “Never Take the Rule of Law for Granted: China and the Dissident,” will be held Saturday, Sept. 20, at 4 p.m. at the Norfolk Library. It brings together Jerome A. Cohen, author of “Eastward, Westward: A Life in Law,” and Mark Clifford, author of “The Troublemaker: How Jimmy Lai Became a Billionaire, Hong King’s Greatest Dissident, and China’s Most Feared Critic” in dialogue with journalist Richard Hornik to discuss the rule of law and China.
The Council on Foreign Relations stated, “Few Americans have done more than Jerome A. Cohen to advance the rule of law in East Asia. He established the study of Chinese law in the United States. An advocate for human rights, Cohen has been a scholar, teacher, lawyer, and activist for sixty years.”
Cohen, a professor at New York University School of Law and director of its U.S.-Asia Law Institute, revealed his long view on China: “We are now witnessing another extreme in the pendulum’s swing toward repression. Xi Jinping is likely to outlive me but ‘no life lives forever.’ There will eventually be another profound reaction to the current totalitarian era.”
Mark Clifford, author of “The Troublemaker: How Jimmy Lai Became a Billionaire, Hong Kong’s Greatest Dissident, and China’s Most Feared Critic.”Haystack Book Festival
In “The Troublemaker,” Clifford chronicles Lai’s life from child refugee to pro-democracy billionaire to his current imprisonment by the Chinese Communist Party. Clifford is president of the Committee for Freedom in Hong Kong Foundation, a Walter Bagehot Fellow at Columbia University, and holds a PhD in history from the University of Hong Kong. He was the former editor-in-chief of the South China Morning Post and The Standard (Hong Kong and Seoul).
Journalist Richard Hornik, adjunct senior fellow at the East-West Center in Honolulu.Haystack Book Festival
Richard Hornik, adjunct senior fellow at the East-West Center, will moderate the discussion. Hornik is the former executive editor of AsiaWeek, news service director of Time magazine, and former Time bureau chief in Warsaw, Boston, Beijing and Hong Kong.
Betsy Lerner, author of “Shred Sisters,” is giving the 2025 Brendan Gill lecture at the Haystack Book Festival.Haystack Book Festival
The Brendan Gill Lecture is a highlight of the festival honoring longtime Norfolk resident Brendan Gill, who died in1997. Gill wrote for The New Yorker magazine for fifty years. Betsy Lerner, New York Times-recognized author of “Shred Sisters,” will deliver this year’s lecture on Friday, Oct. 3, at 6 p.m. at the Norfolk Library.
Visit haystackbookfestival.org to register. Admission is free.