Model and Measurements of an Optical Stack for Broadband Visible to Near-Infrared Absorption in TiN MKIDs.

Typical materials for optical Microwave Kinetic Inductance Detetectors (MKIDs) are metals with a natural absorption of ∼ 30-50% in the visible and near-infrared. To reach high absorption efficiencies (90-100%) the KID must be embedded in an optical stack. We show an optical stack design for a 60 nm TiN film. The optical stack is modeled as sections of transmission lines, where the parameters for each section are related to the optical properties of each layer. We derive the complex permittivity of the TiN film from a spectral ellipsometry measurement. The designed optical stack is optimised for broadband absorption and consists of, from top (illumination side) to bottom: 85 nm SiO2, 60 nm TiN, 23 nm of SiO2, and a 100 nm thick Al mirror. We show the modeled absorption and reflection of this stack, which has >80% absorption from 400 to 1550 nm and near-unity absorption for 500-800 nm. We measure transmission and reflection of this stack with a commercial spectrophotometer. The results are in good agreement with the model.

Cost-minimization analysis of alemtuzumab compared to fingolimod and natalizumab for the treatment of active relapsing-remitting multiple sclerosis in the Netherlands.

AIM: In active relapsing remitting multiple sclerosis (RRMS) patients requiring second-line treatment, the Dutch National Health Care Institute (ZiN) has not stated a preference for either alemtuzumab, fingolimod, or natalizumab. The aim was to give healthcare decision-makers insight into the differences in cost accumulation over time between alemtuzumab-with a unique, non-continuous treatment schedule-and fingolimod and natalizumab for second-line treatment of active RRMS patients in the Netherlands. METHODS: In line with ZiN's assessment, a cost-minimization analysis was performed from a Dutch healthcare perspective over a 5-year time horizon. Resource use was derived from hospital protocols and summaries of product characteristics, and validated by two MS specialists. Unit costs were based on national tariffs and guidelines. Robustness of the base case results was verified with multiple sensitivity and scenario analyses. RESULTS: Alemtuzumab results in cost savings compared to fingolimod and natalizumab from, respectively, 3.3 and 2.8 years since treatment initiation onwards. At 5 years, total discounted costs per patient of alemtuzumab were €79,717, followed by fingolimod with €110,044 and natalizumab with €122,238, resulting in cost savings of €30,327 and €42,522 for alemtuzumab compared to fingolimod and natalizumab, respectively. Key drivers of the model are drug acquisition costs and the proportions of patients that do not require further alemtuzumab treatment after either two, three, or four courses. LIMITATIONS: No treatment discontinuation and associated switching between treatments were incorporated. Consequences of JC virus seropositivity while continuing natalizumab treatment (e.g. additional monitoring) were omitted from the base case. CONCLUSION: The current cost-minimization analysis demonstrates that, from the Dutch healthcare perspective, treating active RRMS patients with alemtuzumab results in cost savings compared to second-line alternatives fingolimod and natalizumab from ∼3 years since treatment initiation onwards. After 5 years, alemtuzumab's cost savings are estimated at €30k compared to fingolimod and €43k compared to natalizumab.