Nocco, a pharmacist and former detailer herself, is an "academic" detailer.
She is paid to sell the truth, or at least Harvard's version of it.
Her unusual job is to give doctors objective information about the cost and benefits of all kinds of treatments, including diet and exercise. Her work is supported by the state of Pennsylvania's PACE program, which helps more than 300,000 poor senior citizens pay for their medications.
The goal is to foster better care and maybe save PACE, which spends $600 million a year on drugs, some money in the process.
"If you just practice smart, you'll be able to give better care and, by the way, save money," said Jerry Avorn, a Harvard University internist and drug expert whose team of doctors is paid by PACE to scour scientific studies and create the reports that detailers like Nocco give doctors.
On this day, Nocco, polished and enthusiastic, arrived armed with breakfast from Dunkin' Donuts for the staff and a stack of information on high blood pressure for Jewell. Before the doctor started seeing patients at 9 a.m., the two raced through thiazide diuretics - "a very cost-effective way to start" - ACE inhibitors, ARBs, beta-blockers, calcium channel blockers, and the widely ignored recommendation to eat right and exercise more.
Jewell said she knew most of it already but appreciated the refresher course and the slick, readable materials Nocco left for her and patients.
Company detailers have been demonized, but Jewell likes them. The drug samples they bring help her patients, she said, and the reps help her keep up to date on the newest drugs. But she limits visits to about 10 a week, by appointment only. And she's well aware that the detailers' job is to sell drugs.
"You always have to wonder how much of their message is marketing and how much is actual science," she said.
She called the PACE detailing program, known as the Independent Drug Information Service, "refreshing."
