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More than 160 cases of transfusion\u2010transmitted B<\/jats:styled-content>abesia\u2009microti<\/jats:italic> (TTB<\/jats:styled-content>) have been reported to date, yet there is little consensus regarding a mitigation strategy.<\/jats:p><\/jats:sec>Study Design and Methods<\/jats:title>This study sought to assess the cost\u2010utility of donation screening by mode of testing (immunofluorescence assay, enzyme\u2010linked immunosorbent assay [ELISA<\/jats:styled-content>], polymerase chain reaction [PCR<\/jats:styled-content>], and combinations thereof) as well as extent of geographic inclusion (4\u2010state, 7\u2010state, 20\u2010state, or national screening). A discrete\u2010time M<\/jats:styled-content>arkov cohort model to simulate the outcomes of B<\/jats:styled-content>.\u2009microti<\/jats:italic> infection and survival of the transfused population was developed. Seroprevalence was estimated by extrapolating babesiosis claims from the C<\/jats:styled-content>enters for M<\/jats:styled-content>edicaid and M<\/jats:styled-content>edicare S<\/jats:styled-content>ervices and reports to the C<\/jats:styled-content>enters for D<\/jats:styled-content>isease C<\/jats:styled-content>ontrol and P<\/jats:styled-content>revention. Test performance was estimated from clinical diagnostics and limited donor screening studies, while transmissibility was estimated as a weighted average of three studies. Results are reported as the cost per quality\u2010adjusted life\u2010year (QALY<\/jats:styled-content>) for each strategy compared to no screening.<\/jats:p><\/jats:sec>Results<\/jats:title>Given model inputs, 4\u2010state and 7\u2010state ELISA<\/jats:styled-content> in combination with PCR<\/jats:styled-content> would cost $5.2 million and $6.6 million\/QALY<\/jats:styled-content>, respectively. Cost\u2010effectiveness for 20\u2010state and national screening strategies were less favorable.<\/jats:p><\/jats:sec>Conclusion<\/jats:title>Targeted screening in states with the highest seroprevalence of infection is likely to exceed an implicit threshold of $1 million\/QALY<\/jats:styled-content> often used in blood safety. However, the proportion of donor\u2010seronegative parasitemia, transmissibility, and clinical outcomes resulting from TTB<\/jats:styled-content> are uncertain.<\/jats:p><\/jats:sec>","DOI":"10.1111\/trf.12805","type":"journal-article","created":{"date-parts":[[2015,1,30]],"date-time":"2015-01-30T00:41:28Z","timestamp":1422578488000},"page":"2245-2257","source":"Crossref","is-referenced-by-count":33,"title":["Costs, consequences, and cost\u2010effectiveness of strategies for B<\/scp>abesia microti<\/i> donor screening of the US<\/scp> blood supply"],"prefix":"10.1111","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0229-8843","authenticated-orcid":false,"given":"Alex J.","family":"Goodell","sequence":"first","affiliation":[{"name":"Blood Systems Research Institute San Francisco California"},{"name":"UC Berkeley\u2013UCSF Joint Medical Program UCSF San Francisco California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Evan M.","family":"Bloch","sequence":"additional","affiliation":[{"name":"Blood Systems Research Institute San Francisco California"},{"name":"Department of Laboratory Medicine UCSF San Francisco California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter J.","family":"Krause","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Yale School of Public Health New Haven Connecticut"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brian","family":"Custer","sequence":"additional","affiliation":[{"name":"Blood Systems Research Institute San Francisco California"},{"name":"Department of Laboratory Medicine UCSF San Francisco California"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2014,8,11]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1202018"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.00022-10"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1537-2995.2009.02494.x"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-155-8-201110180-00362"},{"key":"e_1_2_8_6_1","first-page":"505","article-title":"Babesiosis surveillance\u201418 States, 2011","volume":"61","author":"Centers for Disease Control and Prevention (CDC)","year":"2012","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.2003.68.431"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.158.19.2149"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.3109\/15622975.2011.572998"},{"key":"e_1_2_8_10_1","unstructured":"US Food and Drug Administration.Risk of Babesia Infection by Blood Transfusion and Potential Strategies for Donor Testing.2010. 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