ABSTRACT
BACKGROUND: We conducted an economic assessment using test data from the phase III TRIPLE study, which examined the efficacy of a 5-hydroxytryptamine 3 receptor antagonist as part of a standard triplet antiemetic regimen including aprepitant and dexamethasone in preventing chemotherapy-induced nausea and vomiting in patients receiving cisplatin-based highly emetogenic chemotherapy (HEC). METHODS: We retrospectively investigated all medicines prescribed for antiemetic purposes within 120 h after the initiation of cisplatin administration during hospitalization. In the TRIPLE study, patients were assigned to treatment with granisetron (GRA) 1 mg (n = 413) or palonosetron (PALO) 0.75 mg (n = 414). The evaluation measure was the cost-effectiveness ratio (CER) assessed as the cost per complete response (CR; no vomiting/retching and no rescue medication). The analysis was conducted from the public healthcare payer's perspective. RESULTS: The CR rates were 59.1% in the GRA group and 65.7% in the PALO group (P = 0.0539), and the total frequencies of rescue medication use for these groups were 717 (153/413 patients) and 573 (123/414 patients), respectively. In both groups, drugs with antidopaminergic effects were chosen as rescue medication in 86% of patients. The costs of including GRA and PALO in the standard triplet antiemetic regimen were 15,342.8 and 27,863.8 Japanese yen (JPY), respectively. In addition, the total costs of rescue medication use were 73,883.8 (range, 71,106.4-79,017.1) JPY for the GRA group and 59,292.7 (range, 57,707.5-60,972.8) JPY for the PALO group. The CERs (JPY/CR) were 26,263.4 and 42,628.6 for the GRA and PALO groups, respectively, and the incremental cost-effectiveness ratio (ICER) between the groups was 189,171.6 (189,044.8-189,215.5) JPY/CR. CONCLUSIONS: We found that PALO was more expensive than GRA in patients who received a cisplatin-based HEC regimen.
ABSTRACT
We present the modeling and the experiment on the lateral integration of a vertical-cavity surface-emitting laser (VCSEL) and slow light Bragg reflector waveguide devices. The modeling shows an efficient direct-lateral coupling from a VCSEL to an integrated slow light waveguide. The calculated result shows a possibility of 13 dB chip gain and an extinction ratio over 5 dB for a compact slow light semiconductor optical amplifier (SOA) and electroabsorption modulator integrated with a VCSEL, respectively. We demonstrate an SOA-integrated VCSEL, exhibiting the maximum output power over 6 mW. Also, we fabricate a sub-50-µm long electroabsorption modulator laterally integrated with a VCSEL. An extinction ratio of over 15 dB for a voltage swing of 2.0 V is obtained without noticeable change of threshold. In addition, we demonstrate an on-chip electrothermal beam deflector integrated with a VCSEL.
ABSTRACT
We present a new type of wavelength demultiplexers based on a Bragg reflector waveguide, which provides a large angular dispersion of 1~2°/nm. Benefiting from its large steering bandwidth and sharp divergence angles, we record a number of resolution-points (possible channel-count in demultiplexing) over 200 and 1,000 for active-type and passive-type devices, respectively. It is the highest number in various multiplexing elements ever reported. The device size is as small as a few millimeters.
ABSTRACT
We propose a novel beam-steering device based on a slow-light waveguide amplifier. In this paper, we present the idea of this steering technique and show its modeling characteristics. Giant steering of the radiation beam is obtained by tuning the wavelength of input light, which is coupled into the Bragg reflector waveguide. A tunable deflection-angle range can be over 40 degrees. High beam coherency and flat intensity distribution enable us to obtain an ultra-large number of resolution-points over 1,000 for few-millimeter long devices.
