January 7, 2019

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Sports January 7, 2019

Eagles' Defeat Of The Bears Revives The Question: Does Icing The Kicker Work?

The Chicago Bears kicker missed a game-winning field goal Sunday night, after the Eagles called time-out. NPR’s Audie Cornish talks with economist Toby Moskowitz about the practice of icing a player.



AUDIE CORNISH, HOST:

Last night, the Chicago Bears fell victim to one of the most debated tricks in the coaching book – icing the kicker. Here’s what happened. With seconds to go in their NFL playoff game against the Philadelphia Eagles, Bears kicker Cody Parkey lines up for a field goal. They’re down by one, so the game is riding on this kick, OK? The ball is snapped. The kick goes up and sails through the uprights, except that it doesn’t count. The NBC announcers don’t sound surprised. They know exactly what happened.

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AL MICHAELS: Doug Pederson knowing – yep, getting that timeout just before the snap.

CORNISH: The Eagles’ coach called a timeout right before the play. That’s icing the kicker. It’s supposed to rattle his nerves, get in his head. So Cody Parkey has to do it over again. And this time, the announcers are surprised.

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MICHAELS: And – oh, he hits the upright again. That’s impossible.

CORNISH: Ouch – the kick bounces out. Bears lose. Eagles win. A debate is reignited because people keep talking about this idea. Does icing the kicker work? Well, joining us now is Toby Moskowitz. He investigated this question in his book “Scorecasting.” Welcome to ALL THINGS CONSIDERED.

TOBY MOSKOWITZ: Thank you. Thanks for having me.

CORNISH: All right, so to begin, I try and put myself in the mind of a kicker. Is this something that would, you know, rattle one? It’s a high-stakes moment of the game.

MOSKOWITZ: Well, you know what? You would be rattled. I would be rattled. But a professional football kicker shouldn’t be rattled. I think nowadays most kickers fully expect to be iced, meaning that they know the opposing coach is going to call a timeout right before they kick, and they’re mentally prepared for that.

The other thing is these kickers have kicked thousands and thousands of kicks. I don’t even think they’re aware of what else is going on in the field. They’re just – it’s like asking Roger Federer, are you nervous when you hit a second serve? I don’t even think he thinks about it. It’s just so automatic.

CORNISH: Now, let’s get to the numbers. Is it effective?

MOSKOWITZ: So we crunched the numbers several years ago. We added up all kicks over about a decade worth in the NFL, and we looked at times when the kicker in pressure situations was iced versus not iced. And what we found was the success rate was really no different between the two situations. Suppose I hit my kicks from that distance about 70 percent of the time. You’d expect me to miss 30 percent of the time. Well, icing the kicker doesn’t cause you to miss. It’s just that kickers will miss that kick about 30 percent of the time. And some of those times, about half the time, the coach will call a timeout.

You know, it feels like you’re getting in the kicker’s head. But at least if you look at the numbers on the field – and again, you’re controlling for distance and the difficulty of the kick. Whether or not a timeout is called right before the kick doesn’t really make much of a difference.

CORNISH: So why do coaches like it?

MOSKOWITZ: So that’s an interesting question, and we thought about this as well. One aspect is, you know, I think at that point in the game – and you take last night as an example – what’s a coach supposed to do? Doug Pederson’s options are to sit there and wait while the final 10 seconds tick and he sees whether the ball goes through the uprights or not. Or he’s got some timeouts left at his disposal. His fans want him to do something. His players might even want him to do something. Even he might feel like he wants to do something. So why not try it, right?

Imagine the ball goes through the uprights and he didn’t call the timeout. The Philadelphia fans are now going to be screaming, oh, if you’d only iced the kicker, whereas I think if he does it and Parkey hits it last night – he ices him, but he makes it anyway – no one’s going to blame him. There’s nothing else he could have done. But leaving something on the table that people feel like you could have done – psychologically, we just don’t like that.

CORNISH: Toby Moskowitz is professor of finance at Yale University. He’s co-author of “Scorecasting: The Hidden Influences Behind How Sports Are Played And Games Are Won.” Thank you so much, Toby.

MOSKOWITZ: Thank you.

Copyright © 2019 NPR. All rights reserved. Visit our website terms of use and permissions pages at www.npr.org for further information.

NPR transcripts are created on a rush deadline by Verb8tm, Inc., an NPR contractor, and produced using a proprietary transcription process developed with NPR. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.

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Business January 7, 2019

The Stakes Are High As China And The U.S. Resume Trade Talks.

NPR’s Ari Shapiro talks with Wendy Cutler, vice president of the Asia Society Policy Institute and a former U.S. trade negotiator, about the U.S.-China trade talks which resumed Monday in Beijing.



ARI SHAPIRO, HOST:

The U.S. and China resumed trade talks in Beijing today. Negotiators picked up where President Trump and Chinese President Xi Jinping left off on December 1. The leaders agreed to a 90-day truce in the trade war, a temporary hold on any additional tariffs. If there’s no deal, Trump says he’ll increase tariffs on a bunch of Chinese goods March 1. Over the weekend, he sounded optimistic.

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PRES DONALD TRUMP: The China talks are going very well. I spoke to President Xi recently. I really believe they want to make a deal. The tariffs have absolutely hurt China very badly.

SHAPIRO: Wendy Cutler is a former U.S. trade negotiator and now vice president of the Asia Society Policy Institute. Welcome.

WENDY CUTLER: Thank you.

SHAPIRO: What’s the goal of the U.S. delegation in Beijing this week?

CUTLER: I think their primary goal will be to assess the seriousness of the Chinese delegation in addressing the range of U.S. concerns with respect to China’s market. Now, those include the lack of market access, high tariffs, high bilateral trade deficit, forced technology transfer, lax intellectual property protection enforcement and other issues as well.

China has rolled out in the past few weeks a number of measures and have made a number of announcements about increasing purchases of U.S. soybeans, temporarily reducing the U.S. auto tariff and stepping up IPR enforcement.

SHAPIRO: That’s intellectual property rights.

CUTLER: Correct. And at this meeting, I think the United States will be very interested on hearing more details and more specificity and the time frames for these announcements that China has made. And I think they’ll also be looking for additional concessions by China as well.

SHAPIRO: So we just heard President Trump say he thinks China has a vested interest in cutting a deal because U.S. tariffs are hurting them. Do you see evidence of that? Do you think that’s true?

CUTLER: Absolutely. I think the tariffs are having an effect on the Chinese economy, but I also think they’re affecting the U.S. economy. So I think both sides are coming to the table, trying to strike a deal, wanting a deal, but I don’t think a deal at any cost. And so we’ll have to see if they can find common ground if both sides have the flexibility to move off their positions and to find a negotiated solution.

SHAPIRO: And how absolute do you think that March deadline is? If the two sides are close to a deal, do you think it could move?

CUTLER: Oh, I think that if substantive progress is made and some breakthroughs are made on certain issues, that we may see a rollover of the talks and the continuation of the tariff truce while both sides continue to negotiate. That’s normal.

SHAPIRO: You know, President Trump can be so impulsive. He often undermines aides and contradicts advisers. Do you think the parties can negotiate in good faith here, or is there a risk that Trump might blow up whatever they might agree to?

CUTLER: As we’ve seen, there’s always a risk, as you mentioned. That said, I think the fact that Ambassador Lighthizer is leading these talks is very important. I think the president has a lot of confidence in Ambassador Lighthizer, particularly…

SHAPIRO: This is Ambassador Robert Lighthizer, the U.S. trade representative.

CUTLER: Correct, particularly given Lighthizer’s success in negotiating the U.S.-Mexico-Canada agreement. And so I think that Lighthizer goes into these talks with a lot of credibility and the backing of the president.

SHAPIRO: And what are the stakes here if the two sides can’t reach a deal?

CUTLER: The stakes are extremely high. I think if the tariffs go up to 25 percent on $200 billion worth of Chinese imports into the United States, the U.S. is going to be feeling this very quickly across our economy. And I think there’ll be quick reverberations in our markets. And I think that the Chinese markets in other corners of their economy will respond as well. And I think overall global economic growth will sink. And so the stakes are very high.

SHAPIRO: That’s Wendy Cutler, former acting deputy U.S. trade representative during the Obama administration, now with the Asia Society Policy Institute. Thanks a lot.

CUTLER: Thank you.

Copyright © 2019 NPR. All rights reserved. Visit our website terms of use and permissions pages at www.npr.org for further information.

NPR transcripts are created on a rush deadline by Verb8tm, Inc., an NPR contractor, and produced using a proprietary transcription process developed with NPR. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.

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Health January 7, 2019

Prescription Drug Costs Driven By Manufacturer Price Hikes, Not Innovation

While some new drugs entering the market are driving up prices for consumers, drug companies are also hiking prices on older drugs.

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The skyrocketing cost of many prescription drugs in the U.S. can be blamed primarily on price increases, not expensive new therapies or improvements in existing medications as drug companies frequently claim, a new study shows.

The report, published Monday in the journal Health Affairs, found that the cost of brand-name oral prescription drugs rose more than 9 percent a year from 2008 and 2016, while the annual cost of injectable drugs rose more than 15 percent.

“The main takeaway of our study should be that increases in prices of brand-name drugs were largely driven by year-over-year price increases of drugs that were already in the market,” says Immaculata Hernandez, an assistant professor of pharmacy at the University of Pittsburgh, and the lead author of the study.

The price of insulin, for example, doubled between 2012 and 2016, according to the Health Care Cost Institute. And the price of Lantus, an insulin made by Sanofi, rose 49 percent in 2014 alone, according to the University of Pittsburgh.

The researchers used the wholesale acquisition cost data for more than 27,000 prescription drugs from First Databank, a company that collects prescription drug sales data. It then compared that data to claims data from the University of Pittsburgh Medical Center’s health plan, which the researchers say is a sample that mirrors the population as a whole.

They then compared new and existing drugs and separated the data into brand-name, generic and specialty categories to come up with cost increase estimates.

Brand-name drugs like Lantus and others account for an average 44 percent of total prescription drug spending, Hernandez says. That share is declining as drugmakers focus more on developing high-priced specialty medications, she says.

Gerard Anderson, professor of health policy and management at Johns Hopkins University, says price increases on existing drugs not only benefit drug makers, but also insurers, who can make more money through rebates on higher priced drugs.

“Research and development is only about 17 percent of total spending in most large drug companies,” he says. “Once a drug has been approved by the FDA, there are minimal additional research and development costs so drug companies cannot justify price increases by claiming research and development costs.”

The study did find that innovation was behind price increases for certain types of drugs. Hernandez and her team found that from 2008 to 2016, the price of so-called specialty drugs rose 21 percent for oral medications and 13 percent for injectable drugs. These increases were driven by new, innovative drugs like Sovaldi and Harvoni, two medications made by Gilead Sciences, Inc. that can cure Hepatitis C. Both drugs were initially priced at over $80,000 for a course of treatment.

Total spending by the government, consumers and insurers on prescription drugs was $333 billion in 2017, according to National Health Expenditure data. That was an increase of just 0.4 percent from the previous year. But that spending rose more than 41 percent over the previous decade, from $236 billion in 2007.

The researchers say their study is based on the list prices of medications and doesn’t take into account the discounts most insurance companies get for prescription drugs because those discounts are kept secret.

The study also showed big cost increases in generic drugs, with oral generics rising 4 percent a year and injectables increasing 7 percent annually. But Hernandez says that spike can be attributed to what she calls a “patent cliff” that hit the drug market during the study period in which several blockbuster drugs, including several anti-depressants and anti-psychotics, lost their patent protection and became generics.

“We’re talking here about highly used drugs,” Hernandez says. “And it takes some time to file generic applications and therefore in the first years after a patent expiration there’s less competition in the market.” So at first, prices are set very close to the brand name price.

So those high-volume, expensive generics drove up prices in the generic market overall. But, as more generic competitors hit the market, the prices begin to fall more, she says.

Since rising costs aren’t paying for improved treatments, policy makers may want to take action, says Dr. William Shrank, chief medical officer of the UPMC Health Plan, who is also an author on the study.

“This observation supports policy efforts designed to control health care spending by capping price inflation to some reasonable level,” he says.

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