(FORTUNE Magazine) – The cost of prescription drugs soared to $154 billion last year, up 17% from 2000. Pundits have blamed rising R&D outlays, relentless TV ads, and greedy pharma conglomerates for the jump. But we wonder...has anyone considered pens as the culprit?

In a recent survey of doctors' offices, FORTUNE unearthed a dazzling array of plastic, chrome, and wood pens emblazoned with everything from Allegra and Aricept to Zithromax and Zoloft. (Our favorite: a sleek silver and gray beauty, courtesy of Viagra.) Though it's impossible to track drug pen expenditures, as Henry Morgan of PENSRUS on Staten Island notes, "Every time a drug company comes out with a new drug, they put the name on a pen and get it to as many doctors as they can."

On July 1 the drug industry will launch a new (voluntary) code of conduct banning gifts like basketball tickets and Tahitian trips, but small giveaways will still be allowed. Our prediction? Big Pharma will likely come down with a new case of pen pushing.

--Lawrence A. Armour