All those drug-branded pens and calendars have become something of a hot-button political issue. Last month, the Massachusetts House of Representatives voted to repeal the state's 2008 gift ban, which regulates interactions between physicians and the pharmaceutical industry. The American Medical Student Association is among the vocal supporters of the ban and, as part of its PharmFree campaign has advocated "the elimination of all pharmaceutical marketing gifts including meals, coffee mugs, pens and anything else that unnecessarily increases the cost of health care." Though the future of the Bay State ban on "gifts" remains undecided, pharmaceutical companies have tried to head off other restrictions with voluntary ban. In 2008, member companies of the Pharmaceutical Research and Manufacturers of America established voluntary, self-policed guidelines that prohibit sales reps from providing most of these items. Among those member companies were Abbott ( ABT), Bristol-Myers Squibb ( BMY), Eli Lilly ( LLY), Johnson & Johnson ( JNJ), Merck ( MRK), Novartis ( NVS) and Pfizer ( PFE). "When the pharmaceutical company guidelines went into place, between $700 million and $1 billion in sales went away," Andrews says. "I think they were offering that as a way to avoid more, potentially restrictive legislation. We are now seeing some cracks in that. Some companies are not necessarily following it, because there is no law that says they have to, but more importantly our distributors and suppliers have been creating products that do fit within the guidelines." "Those guidelines, though restrictive, do allow items that are educational in nature or informative in nature," he adds. "So things like patient kits, digital photo frames, anatomical charts, these are some of the many kinds of unique promotional products that can still be given for a physician to either give to his patients or use in their office. The stringent guidelines have certainly reduced ink pens and some of the more casual kinds of things. But it actually brings everything up another level. Having the ability to be educational or informative has created an opportunity for us." Nevertheless, Andrews says his organization is "trying to convince lawmakers that promotional products are advertising, not gifts." "If I give you a mug with your name on it, is that really going to change what prescription you write for somebody? It puts the drug's name and proper spelling out there, with maybe some drug interaction stats and educational material for you to be informed as a physician," he says. "That is important. But these truly are not gifts and shouldn't be judged as such. These items are a lot different than a two-week vacation in Tahiti." -- Written by Joe Mont in Boston. >To contact the writer of this article, click here: Joe Mont. >To follow the writer on Twitter, go to http://twitter.com/josephmont. >To submit a news tip, send an email to: email@example.com.