Proclaiming 2009 to be their year for ethical behavior, Big Pharma self-imposed a moratorium on the practice of handing out branded trinkets to physicians, pharmacists and others who write its checks.

So say good-bye to the black rhinestone BOTOX T-shirts, the Lunesta mugs with the sleepy moth, Viagra push pens and Seroquel staplers.

The Pharmaceutical Research and Manufacturers of America, after adding Mahatma Gandhi, the Dalai Lama and Nelson Mandela to its board, authored the guidelines and 40 drug makers quickly signed on.

The code builds on a 2002 version which outlawed distribution of pricier perks like tickets to shows and pro sporting events. It also asks that companies financing medical conferences leave curriculum development to arms-length program coordinators.

The code does not prevent companies from sponsoring take-in lunches for physicians and their office staff or restaurant dinners for physicians, assuming they are accompanied by an educational seminar.

It also doesn’t prevent companies from giving away free drug samples to doctors, which they did in 2007 to the tune of $15 billion, and it continues to permit companies to pay physicians as consultants at “fair market value” which translates to tens of thousands of dollars per year in many cases.

“Pens or no pens, their influence is not going to be diminished,” Larry Greenbaum, a rheumatologist in Greenwood, Indiana told the New York Times.

But others mourn the loss and dismiss the notion that trinkets influence prescribing decisions. “It seems goofy to us. We like getting our pens,” lamented Susan Hurson, a Washington Ob-Gyn.

Pizaazz recommends the opposite strategy: allow physicians to sell space on their white coats like it was the hood of a NASCAR. It would make doctor visits more exciting and people would know straight away which company bought them off.

Twenty-five years after tamoxifen was introduced for the treatment of breast cancer, David Flockhart and his team at Indiana University determined that the body coverts the drug into a different substance known as endoxifen, and the latter is actually the cancer-figher.

Flockhart’s group discovered that the body uses an enzyme known as 2D6 to engineer the conversion, and that there is considerable variation in 2D6 gene expression.

In fact 7% of the general population possess a wholly inactive enzyme and another 20-40% have a weakly active variation.

Flockhart told the New York Times that was “scary” because it meant tens of thousands of women had received a drug that did not protect them against recurrent breast cancer as they had thought.

It’s scary for Big Pharma too. Tamoxifen had fallen out of favor ever since clinical trials showed that aromatase inhibitor drugs performed better.

But the studies were done before we knew about 2D6 and as an aside, the aromatase inhibitors net up to 36 times more revenue per patient than the now-generic tamoxifen.

Suppose the trials had assessed only women with a fully active 2D6 enzyme. Could tamoxifen have performed as well or better than the aromatase inhibitors? 

Matthew Goetz and colleagues from the Mayo clinic went back and checked tumor samples from a previous trial for 2D6 gene status and reported that 32% of women with the inactive variant had relapsed or died in 2 years. Only 2% percent of women with a fully active enzyme relapsed or died.

But other studies reached contradictory conclusions and it turns out there are dozens of 2D6 variants which can confound results in clinical labs.

Two years ago, an FDA advisory panel recommended that the 2D6 test be discussed on the label for tamoxifen. Just recently, the agency got around to accepting the recommendation.

Normally a college degree helps people secure employment, even during economic downturns. It also confers job security in that college-educated employees are less likely to be riffed during a recession.

But no one is immune from the Great Economic Crisis of ’08-‘09.

Or, as Lawrence Mishel, an economist with the Economic Policy Institute told the Washington Post, “In a flood everyone gets swept away.”

In November, 3.1% of workers with at least a college diploma were unemployed. That’s less than half the national unemployment rate of 7.2% and far less than the rate of 10.5% among those who did not graduate high school, but it’s higher than at any point since 2003.

And many analysts believe the rate will soon exceed 4%, making it the highest unemployment rate among college grads since the Bureau of Labor Statistics started tracking unemployment by educational level 38 years ago.

Part of the challenge facing college grads, especially younger ones, is that the few employers who are hiring can afford to be selective due to the surge in capable candidates. They’re looking for experience and mastery of a wide range of tasks, which recent graduates don’t have.

For many it seems, the best option is to trade down; accept positions for which you’re overqualified or even those outside your field, at least until things start brightening up out there.

“We’re telling candidates . . . your next job may not have the title you want or the pay you want,” John Owen told the Post. Post helps Robert Half place finance and accounting professionals.