A Plus!-I have been looking for a pen and pencil for my arthritic hands that works for me, but to no avail. To my surprise, this one is Ideal!! Smooth and easy writing which helps too. I really like the pen and pencil in one. No more fumbling for the correct writing tool. The lead that came with this item is a little darker and does not break easily. The only difference I can see on the labels that are attached to the Bic refill cases that I already have, is that these are made strickly in France.