A growing number of medical centers are cracking down on even small pharmaceutical company gifts to doctors, saying token items can influence behavior, the AP reports.Among the items drug company reps are being barred from handing out at the Hospital of the University of Pennsylvania are pens, notepads and free pizza.The Penn system already had some restrictions in place, such as requiring drug reps to make appointments to call on physicians.But more limits were needed, said the Penn health system’s chief medical officer. Thirty-nine percent of physicians said they wanted reps banned altogether. The new rules go into effect July 1.Earlier this year, Yale University banned all gifts and on-campus meals from drug reps. And last year Kaiser Permanente health system added more rules banning gifts and meals onto its already restrictive gifting policies.Dr Jordan Cohen, president of the Association of American Medical Colleges, applauded the moves.However, PhRMA spokesman Scott Lassman told NPR’s “Radio Times” program that the industry believes policies like Penn’s hurt patients because reps have a lot of useful information to impart. He questioned whether a pen or a pizza can influence a physician’s judgment.Cohen, one of the authors of a January article in the Journal of the American Medical Association critiquing current practices, disagreed, saying doctors are highly aware of even nominal items.