Russell WA, et al. – In this study, researchers examined the cost-effectiveness of universal individual donation nucleic acid testing (ID-NAT) in the first year of screening vs alternatives for the 50 states of America and separately for Puerto Rico. Data sources included national testing results compiled by AABB and costs, utilities, and outcome probabilities estimated from the literature. Interventions included universal ID-NAT, universal mini-pool NAT (MP-NAT), and ID-NAT exclusively for components transfused to women of childbearing age. According to findings, MP-NAT only during the season of high mosquito activity was most cost-effective in 64% of probabilistic sensitivity analysis iterations in Puerto Rico. In the 50 states, no screening policy was cost-effective. The cost-effectiveness of screening will be even less favorable during periods with lower rates of Zika-infectious donations.