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Donor screening assays are in development.<\/jats:p><\/jats:sec>Study Design and Methods<\/jats:title>A decision analytic model estimated the cost\u2010effectiveness of screening strategies for preventing transfusion\u2010transmitted babesiosis (TTB<\/jats:styled-content>) in a hypothetical cohort of transfusion recipients in B<\/jats:styled-content>abesia<\/jats:italic>\u2010endemic areas of the U<\/jats:styled-content>nited S<\/jats:styled-content>tates. Strategies included: 1) no screening; 2) U<\/jats:styled-content>niform D<\/jats:styled-content>onor H<\/jats:styled-content>ealth H<\/jats:styled-content>istory Q<\/jats:styled-content>uestionnaire (UDHQ<\/jats:styled-content>), \u201cstatus quo\u201d; 3) recipient risk targeting using donor antibody and polymerase chain reaction (PCR<\/jats:styled-content>) screening; 4) universal endemic donor antibody screening; and 5) universal endemic donor antibody and PCR<\/jats:styled-content> screening. Outcome measures were TTB<\/jats:styled-content> cases averted, costs, quality\u2010adjusted life\u2010years (QALY<\/jats:styled-content>s), and incremental cost\u2010effectiveness ratios (ICER<\/jats:styled-content>s; $\/QALY<\/jats:styled-content>). We assumed a societal willingness to pay of $1 million\/QALY<\/jats:styled-content> based on screening for other transfusion\u2010transmitted infections.<\/jats:p><\/jats:sec>Results<\/jats:title>Compared to no screening, the UDHQ<\/jats:styled-content> avoids 0.02 TTB<\/jats:styled-content> cases per 100,000 RBC<\/jats:styled-content> transfusions at an ICER<\/jats:styled-content> of $160,000\/QALY<\/jats:styled-content> whereas recipient risk\u2013targeted strategy using antibody\/PCR<\/jats:styled-content> avoids 1.62 TTB<\/jats:styled-content> cases per 100,000 RBC<\/jats:styled-content> transfusions at an ICER<\/jats:styled-content> of $713,000\/QALY<\/jats:styled-content> compared to the UDHQ<\/jats:styled-content>. Universal endemic antibody screening avoids 3.39 cases at an ICER<\/jats:styled-content> of $760,000\/QALY<\/jats:styled-content> compared to the recipient risk\u2013targeted strategy. Universal endemic antibody\/PCR<\/jats:styled-content> screening avoids 3.60 cases and has an ICER<\/jats:styled-content> of $8.8 million\/QALY<\/jats:styled-content> compared to universal endemic antibody screening. Results are sensitive to blood donor B<\/jats:styled-content>abesia<\/jats:italic> prevalence, TTB<\/jats:styled-content> transmission probability, screening test costs, risk and severity of TTB<\/jats:styled-content> complications, and impact of babesiosis diagnosis on donor quality of life.<\/jats:p><\/jats:sec>Conclusion<\/jats:title>Antibody screening for B<\/jats:styled-content>abesia<\/jats:italic> in endemic regions is appropriate from an economic perspective based on the societal willingness to pay for preventing infectious threats to blood safety.<\/jats:p><\/jats:sec>","DOI":"10.1111\/trf.12492","type":"journal-article","created":{"date-parts":[[2013,11,20]],"date-time":"2013-11-20T03:37:16Z","timestamp":1384918636000},"page":"889-899","source":"Crossref","is-referenced-by-count":38,"title":["Cost\u2010effectiveness of blood donor screening for B<\/scp>abesia microti<\/i> in endemic regions of the U<\/scp>nited S<\/scp>tates"],"prefix":"10.1111","volume":"54","author":[{"given":"Matthew S.","family":"Simon","sequence":"first","affiliation":[{"name":"Department of Public Health Weill Cornell Medical College New York New York"},{"name":"Department of Medicine Weill Cornell Medical College New York New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jared A.","family":"Leff","sequence":"additional","affiliation":[{"name":"Department of Public Health Weill Cornell Medical College New York New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ankur","family":"Pandya","sequence":"additional","affiliation":[{"name":"Department of Public Health Weill Cornell Medical College New York New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Melissa","family":"Cushing","sequence":"additional","affiliation":[{"name":"Department of Pathology Weill Cornell Medical College New York New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Beth H.","family":"Shaz","sequence":"additional","affiliation":[{"name":"New York Blood Center New York New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David P.","family":"Calfee","sequence":"additional","affiliation":[{"name":"Department of Public Health Weill Cornell Medical College New York New York"},{"name":"Department of Medicine Weill Cornell Medical College New York New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bruce R.","family":"Schackman","sequence":"additional","affiliation":[{"name":"Department of Public Health Weill Cornell Medical College New York New York"},{"name":"Department of Medicine Weill Cornell Medical College New York New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alvin I.","family":"Mushlin","sequence":"additional","affiliation":[{"name":"Department of Public Health Weill Cornell Medical College New York New York"},{"name":"Department of Medicine Weill Cornell Medical College New York New York"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2013,11,19]]},"reference":[{"key":"e_1_2_8_2_1","unstructured":"US Food and Drug Administration.Biological product and hematopoetic cell therapy product (HCT\/P) deviation report\u2014annual summary for fiscal year.2012. 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