Can something as small as the logo on a pen sway a doctor to write a prescription for one drug over another? You bet. Medical students, at least, fall prey to the influence of drug company trinkets, says a study published today in Archives of Internal Medicine.

Big-ticket items, such as a fancy dinner or NBA tickets, might seem like more powerful persuaders than a free ceramic mug. But the researchers conclude that, in fact, "subtle branding exposures are important and influential."

After mounting criticism, many drugmakers halted the flood of pens, notepads and clipboards that kept doctors scribbling within sight of brand-name medicines under a voluntary code adopted by the Pharmaceutical Research and Manufacturers of America (PhRMA) in January. Companies can still take doctors out (as long as there's an 'educational' component to the event) and funnel gifts to those in school.

Even as some states have required pharmacists to dole out generic drugs when they're available and insurers have offered financial incentives to doctors to prescribe them, the cost of prescription medications has continued to climb. Now there's evidence that docs who prescribe electronically are more likely to select generic than pricey brand-name meds.

Massachusetts physicians who used an e-prescribing system increased their use of generics by 6 percent—from 55 percent to 61 percent of all prescriptions they filled—compared with when they wrote them out by hand the old-fashioned way, according to a study in this week's Archives of Internal Medicine. Doctors who weren’t taught to use software that lets them fill 'scripts wirelessly also increased their use of generics, but by only 3 percent (from about 53 percent to 56 percent). The 18-month study involved more than 35,000 doctors, some 2,000 of whom had the option of using the PocketScript software. (The federal Agency for Healthcare Research and Quality and the U.S. National Institutes of Health paid for the study.)

The tumbling economy may be making Americans queasy, but they're apparently so worried about their pocketbooks that they're skipping their meds.

“I’ve seen patients today who said they stopped taking their Lipitor, their cholesterol-lowering medicine, because they can’t afford it,” James King, chairman of the American Academy of Family Physicians, tells the New York Times today. “I have patients who have stopped taking their osteoporosis medication.”

The number of prescriptions filled in the U.S. dropped for the first time in a decade, recent data from the tracking service IMS Health shows. Timothy Anderson of Sanford C. Bernstein & Company, a pharmaceutical analyst, told the Times the 2 percent dip is “most likely tied to a worsening economic environment.”