Pharmacist compounds the competition
There’s something old fashioned about the way Raymond Knepp runs his pharmacy. He and his staff of three know their clients by their individualized remedies, custom– compounded from raw materials. Knepp disdains the corporate centrality of chain drugstores and talks about how native herbs have been used for centuries to heal ailments. The book he pulls first to show a visitor, from a wall of shelved reference materials behind his desk, is “The Physio-Medical Dispensary,” a tome published in 1869Yet there’s something new– millennium about Knepp’s pharmacy as well. He gets about a quarter of his client referrals from the Internet (thewellnesspharmacy.com), and ships his formulations to buyers from Australia to Switzerland. His philosophy of wellness combines the traditions of acupuncture and Kabalistic mysticism with the futuristic thinking of a biotech with a start-up drug under research.
That drug is nanobac, and Knepp says he is the only independent pharmacist to formulate its active agent, a product that seizes bacteria living in arterial plaque. The result is a method of clearing clogged arteries, in a process known as chelation.
“Chelate means to grab onto,” Knepp said. “This product is to clean out coronary arteries.”
The Wellness Pharmacy is working with a Florida-based biotech firm, nanobacLabs, in a study that currently includes about 500 patients nationwide, Knepp said. Knepp has been involved in the project for more than two years, but can’t say when, or even if, the product will be widely released. The process is not your typical pharma company start-up hoping for a break-through drug.
That’s because Knepp knows for certain that nanobac won’t be approved, or even studied, by the U.S. Food and Drug Administration. “The cost to even involve the FDA is just prohibitive, so we won’t,” he said.
According to Knepp, he can compound and sell any formulation, made with any ingredients that medical doctors prescribe, as long as the raw materials aren’t illegal.
“If anything is legally sold in the United States, a physician has the right to prescribe it and the patient has a right to receive it,” Knepp said. “But I’ll be the first to tell you the FDA hates my position on that.”
Knepp articulates the federal government’s policy as one created by the medical establishment to insulate itself and protect its hold on health care. “The FDA will not tolerate any practice that results in a disincentive of pharmaceutical manufacturers to create new drugs,” Knepp said.
He said he learned this philosophy from a Shenandoah University pharmacy professor, Richard Henry Parrish II, who made its proof the point of his 2000 doctoral thesis, “How Government Became the Arbiter of Pharmaceutical Fact.” - The point is, Knepp said, the FDA was created by medical establishment in 1907, and retains its position as the gatekeeper and guardian of mainstream health care.
But Knepp is not mainstream. He earned his pharmacy degree after starting out as an employee of Texas Instruments, with a freshly minted degree in political science. He had been in the corporate world for two years when on May 7,1970, students at Kent State University were shot by National Guardsmen during an anti-Vietnam war protest.
“My colleagues at TI all thought they got what was coming to them, and I got mouthy,” Knepp said. Knepp instructed his colleagues on the constitutional right of free assembly. The company thought it was better off without Knepp, so he accepted a severance package including three months’ pay and “a little profit-sharing check,” and decided to go back to school.
At first, he wanted a farm life and aimed at Texas A&M. But when he wasn’t accepted for veterinary school, he looked toward a pharmacy profession. Knepp said he didn’t enjoy pharmacy school, because “it was just bookwork and memorization,” but he is gratified by what he does now. “I think I’m doing what I’m supposed to do,” he said.
Still, it took Knepp 13 years as a mainstream pharmacist before he deviated. He owned a franchised independent pharmacy in Front Royal, until what he perceived as the futility of mainstream medicine combined with a continual pay squeeze by insurance companies to force him out.
“I wasn’t accomplishing anything,” Knepp said of his former way of pursuing his profession. “No one was getting well.”
Additionally, Knepp was victimized by what he calls “the predatorization of the insurance industry.” Pharmacists were the first to sign third-party contracts with insurers in the 1980s, Knepp said. These contracts bound them to price caps based on discounted raw materials, but even so, “at that time, the reimbursements were pretty decent,” Knepp said.
But by the early 1990s, insurers were basing reimbursements on averaged wholesale drug prices that they then further discounted by 15%, before adding only $2.50 for the pharmacists’ time and profit margin. Knepp said the worst contract was from Metropolitan Life, which stacked it with base cost estimates that the insurance company dictated. Even filling 200 prescriptions a day couldn’t earn Knepp enough to stay in business.