Used to play with those for a living. The hex is for holding the fastener from rotating, while drawing it in to the hole with the break-off nut. One of the problems is that the fasteners come in several oversizes, and you really need the correct reamer for each size. Plus you need the nuts, if you wanted to use them as intended.
As much as I'd like to have about a gallon jar of those screws just because, mainly I see them as a pretty good bit of agregate for the next concrete foundation pour that comes along.
At one point, my workplace did a purge and threw out all the bin stock we had that was not in it's original packaging. we had a dumpster full of about every kind of hydraulic hose and line fittings you could think of, I filled a gallon bucket with helicoils and other thread repair inserts, screening them through half inch mesh, to only get the smaller sizes... other shops were required to dump out tons of hardware... It was a waste!
But you gotta sort it, or pick through it every time you need something, and you only have so much time on the planet!