Ken Heimann

Ken Heimann, a registered pharmacist, calls the new Wal-Mart $4 generic drug plan, "A deception of the public."Heimann, who graduated from pharmacy school in 1981, worked for nine years as a pharmacist for K-Mart before buying B & W Rexall Pharmacy in Inverness in 1989.Heimann says Wal-Mart's list of drugs is not complete and accurate."They use a bait and switch tactic," he said, adding that Wal-Mart's sales declined last year and the introduction of the plan may have created a spike in their annual sales, according to a CNN report."Unfortunately, the public is being deceived," said Heimann."There's supposedly 189 or 190(290 reported in a news release) drugs in their formulary, and Amoxicillin makes up 12 of those.The scope and depth of the discount being offered is being minimized by repeat drugs."B & W Rexall was in the process of developing a discount plan prior to the introduction of Wal-Mart's plan, "And it was going to be on 90 tablets," said Heimann, "Not the deception with Wal-Mart's plan.Heimann explained that many of the drugs on Wal-Mart's discount generic list are taken 4 times a day, so the cost would actually be $16 per month, not $4 per month.That's why I say it's a little deceptive, a bait and switch.They're going to get you in on this idea, then you'll shop and buy other things in the store, and naturally they're going to benefit.But, all-in-all, I think you're going to lose, in the long run."Heimann said his position on Wal-Mart's drug plan is also the position of the National Community Pharmacy Association and his buying co-op, United Drug.
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Heimann added that drugs tend to fluctuate in price, and prices vary from manufacturer to manufacturer."So, is that an indication that a lesser quality product will be made available?"he asked.According to Heimann, the Wal-Mart plan covers, "A very, very small number of patients, relatively speaking.It's only going to cover a very limited number of prescriptions.You won't see new generic drugs on there, such as generic Zocor and generic Plavix.The cost of those are $110, $130 for a 30-day supply.It's only the very old and inexpensive therapy.Not that many drugs; repeats - different doses of the same drug - of older therapies, still very good therapy, but very, very inexpensive."Heimann said his pharmacy's One-Price Prescription Plan includes generic Zocor and generic Plavix at $5 for a month's supply, or $12.50 for a 90-day supply, a plan that is "far better" than Wal-Mart's.His plan is targeted at what he terms "the donut hole" of Medicare Plan D, an area where there is no coverage."It starts with educating the public," he said."The real issue should be: the patients have a role to play - that is, to encourage the use of generics, whenever possible.It's the only opportunity one has for savings."Heimann said that sales of the newer, brand-name drugs advertised on television, "Are reflective of that advertising effort." Heimann explained that the idea that the original manufacturing process is superior to that of generics is, "A total misinterpretation," that many of the generics are made by the company that originated the product in the same manufacturing facility, with a change of dye on the tablet presses and a different imprint."If someone is manufacturing the generic equivalent, the savings to the consumer is about 20-25%," said Heimann. He feels that small pharmacies will continue to prosper, because patients don't want to be treated as if they are a number, or a commodity.
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Additionally, Heimann says his pharmacy offers a larger variety of healthcare services such as flu shots twice weekly on Tuesdays and Thursdays and pneumonia shots, year-round. Fred Clark, a B & W Rexall customer from Lecanto, explained that the Wal-Mart mediation list shows 295 items, but has only 123 different drugs."The difference is all in various dosages," he said, listing Amoxicillin in various doses as 12 of the 295 drugs.
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Heimann and Dorton both recommend Community Care, a Medicare plan that is individually subscribed.
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Effectively filling in the above-mentioned donut hole on two often-prescribed drugs such as Zocor and Zoloft at $5 per month or $12.50 for a 90-day supply, "These drugs could cost 100% or $100 per month," said Heimann.
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Heimann added, "Our national association says that only one drug out of their (Wal-Mart's) list hits the top 20 drugs."Free medication from drug companies to those who qualify has dwindled significantly, according to Heimann, because, "There is no longer a tax incentive for manufacturers to offer drug therapy to patients who have Medicare, or an opportunity to have Medicare cover their drug therapy," he said. Heimann also said he's been told that large chains can not purchase prescription drugs at a cheaper rate by buying in large volumes, "If it is, it's extremely marginal, not enough to make a difference.If that were the case then, as I said earlier, we have to begin to question the quality of the product and what manufacturers these are coming from."Canadians are buying drugs here and taking them home, said Heimann.He said he fills prescriptions for drugs patients tell him are not available in Canada, "Or if they are available, the product here is less expensive," he said."The movement of drugs across the border is possibly a two-way event, but all we hear about is the Americans going abroad and buying prescription drugs.We're seeing fewer and fewer patients going to Canada, in light of this Medicare Plan and in light of the exchange rate between the American dollar and the Canadian dollar.The product is less appealing, now, because the exchange rate has gotten closer than it was two years ago." Heimann said that problems encountered when signing up for the new medicare plan, Part D are lessening."I think we should have allowed patients more of an opportunity to understand the plan.Every patient who signs up for the plan presents another question, another problem, another challenge that we have to overcome, getting medication to the patient.""Wal-Mart has done a great job of intimidating manufacturers here in the United States," said Heimann, citing televisions as an example."If they can't lower their price, they issue threats, 'We'll go abroad,' and they can do that, causing more manufacturers in the mid-west to close, sometimes with the plant being torn down and replaced with a Wal-Mart Supercenter."Should we be concerned, if they can put enough pressure on drug manufacturers, that if we can't get it for this price we will then begin buying these products abroad?"he queried."Do they have enough legislative power to do that?I don't know; I think it's possible.I'm concerned, because we know that most of the counterfeit drugs that have entered into the United States have come in by way of crossing over the Canadian border," he said.He said Canada does not have the regulatory oversight the United States does by the Food & Drug Administration (FDA), "However much we like to criticize them."By going outside our borders for medication, Heimann feels that we compromise quality or sacrifice safety and accuracy."Wal-Mart is the largest importer of goods from the Pacific rim," said Heimann.

Ken Heimann, pharmacist and owner of B&W Rexall Drugs in Inverness, said late Wednesday that his expected shipment of flu vaccine was not delivered.

That means the hundreds of residents who are expected to show up at the pharmacy today will be turned away.

"It's always been a big event for our community and our store," said Heimann, who's been offering flu vaccines for 12 years.
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Heimann supplies vaccine to doctors, nursing homes and medical facilities in surrounding counties.About 18,000 of Heimann's expected dose supply would have gone to Citrus County residents, he said.

Heimann said he placed the store on a waiting list with the other vaccine supplier, Aventus Pasteur, but he doesn't know when or even if he will receive shipments.

He said he didn't know of the shortage until Tuesday, when he received a faxed message that the first shipment would not be forthcoming.

"We called the Centers for Disease Control looking for direction," he said.
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Heimann said he knows the store will be packed today with residents looking for flu shots.Asked what he thinks the reaction will be, he said: "I'm afraid to even think."

He said one recent year residents by the thousands sought vaccines when they were worried about availability.

"The line went through our store, out the door, down the sidewalk and in front of the Family Tree restaurant on (State Road) 44," he said.

He doesn't know what will happen this year.

"I hope they don't panic.I hope they're able to understand," he said.

"It's definitely had an impact," said Ken Heimann owner of B&W Rexall Drugs in Inverness.He is hoping that his store will eventually win back those customers with face-to-face service.

So far, however, it has presented a challenge.

"The thing that drives people to a small community are the strong values and loyalty," he said."But those people, with those strong values I have found, have shopped at these locations.It's all a price thing.It's troubling because we can't buy it any cheaper."

Heimann said rather than have Canadian storefronts obtain a permit, something should be done to let local drug stores buy the drugs at the same price.

"The real solution is to buy it for the same amount.If that happened, these Canadian storefronts would dry up.It would be a moot issue," he said.