The price associated with blood collection may be perceived to be free for many institutions that have established blood collection labs/service centers; however, there are real costs to sample collection even within these environments. Phlebotomists, lab technicians, medical supplies, and shipping requirements (dry ice, containers, and overnight delivery) add to an estimated $40 per sample, not including freezer storage¹. Oragene, in comparison, comes in a variety of formats with differing yield and stability capabilities which cost between 48% - 80% less. More savings are introduced as Oragene products enable at-home collection, standard shipping via regular mail at room temperature and zero refrigeration.

Daksis, J.I. et al. states, “The acquisition of high quality DNA for molecular assay from oral samples offers clear advantages in cost, handling, storing and shipping over acquisition of samples from blood. … It therefore opens the way for convenient point of care testing…”²

Basham, R.J. et al. claims “…saliva [Oragene.DNA]… allows cost-efficient storage and shipping. In contrast, whole blood must either be extracted within a few days, or stored at −70°C until extracted.”³

Abraham J.E et al. continues “… commercial extraction of DNA from saliva is cheaper than from blood.”⁴

And another study by Nishiya, D.M. et al. reports “Obtaining blood biospecimens presents logistical and financial challenges. As a result, saliva biospecimen collection is becoming more frequent because of the ease of collection and lower cost.” ⁵

That being said, many clinicians and labs benefit from their institution’s internal procurement established for blood collection and are therefore exposed to minimal, if any, costs. But when working with children, psychiatric patients, or remote donors a blood sample is less convenient and more time consuming when a practical alternative exists.

I close with Abraham, J.E et al. “… [Oragene.DNA kits] are more expensive than blood sampling kits however this cost has to be counter-balanced by the increased inconvenience to the patient and the cost of trained staff required to obtain blood samples.” ⁴

In conclusion, can saliva replace blood for DNA collection and analysis? Yes, and in fact it has started to already. Oragene is currently used as an alternative when blood is not a viable option in 250 hospitals worldwide, including 9 of the top 10 hospitals in the United States. Saliva is increasingly becoming an equally important standard practice in healthcare for DNA based sample collection, especially for children, patients with mental health disabilities, and those who cannot efficiently access a blood clinic.

With that, we are closing this series on whether saliva can replace blood for DNA collection and analysis. Be sure to subscribe to our blog so you can be notified of other content like this.

References

¹ Ambrosone C.B. et al. Conducting Molecular Epidemiological Research in the Age of HIPAA: A Multi-Institutional Case-Control Study of Breast Cancer in African-American and European-American Women. J Oncol. 2009: 1-15 (2009).

² CRN: Specimen Collection within the CRN: A critical appraisal.

³ Daksis J.I. and Erikson G.H. Heteropolymeric Triplex-Based Genomic Assay^® to Detect Pathogens or Single-Nucleotide Polymorphisms in Human Genomic Samples. PLoS ONE. 2(3): e305 (2007).

⁴ Abraham, J.E. et al. (2012). Saliva samples are a viable alternative to blood samples as a source of DNA for high throughput genotyping.

⁵ Nishita D.M. et al. Clinical trial participant characteristics and saliva and DNA metrics. BMC Med Res Method. 9(71): 1-20 (2009).