From routine diagnostics to monitoring chronic conditions, clinicians often rely on blood-based measurements to diagnose conditions, monitor disease and treatment progress, and guide treatment decisions. Yet, while the availability of diagnostic markers and analytical methods have advanced greatly in recent decades, the way blood is collected has changed relatively little.
Globally, venous blood draws or venipuncture remain the dominant method for blood sample collection. Patients typically travel to clinics or hospitals where trained phlebotomists collect liquid blood samples, and those samples are transported (if necessary) using cold-chain transport and refrigerated until tested. This method is labor-intensive, facility-dependent, and costly to operate at large scale.
Established feasibility of volumetric self-sampling
Advances in volumetric blood self-sampling make it possible for individuals to collect precise micro-volumes of capillary blood from a fingertip, at home or in other non-clinical settings, without supervision by medical personnel. Microsampling can be performed as both liquid and dried matrix samples. Only dried microsamples can be shipped as regular post under ambient conditions.
Blood microsampling has already demonstrated clinical utility in real-world studies, including large population-based investigations of SARS-CoV-2 infection, where unsupervised, at-home volumetric blood self-sampling was successfully used for biomarker and proteomics analyses at scale (1). Comparable workflows have also been validated in other clinical contexts, including multi-panel drug testing using mass-spectrometry-based analysis, as well as routine at-home HbA1c monitoring in type 1 and type 2 diabetes, with strong agreement between quantitative dried blood samples and venous measurements (2,3). A study in kidney transplant recipients revealed that volumetric finger-prick self-sampling performed by patients at home can achieve sampling success and analytical performance comparable to samples collected by healthcare staff in hospital settings (4).
Several studies have shown that many clinically relevant analytes remain stable in dried blood formats, suggesting that the potential applications of volumetric self-sampling extend far beyond the specific examples described here. These advances raise the question: what does blood collection actually cost, and how might those costs change if a portion of venous blood draws were replaced by self-sampling and ambient temperature transport?
Venipuncture is the dominant approach to blood collection
Venipuncture is cited in peer-reviewed literature as the most common clinical procedure performed worldwide, with an estimated 1.4 billion procedures performed annually in the United States alone (5–7). While this figure does not distinguish between inpatient and outpatient settings, it does illustrate the massive scale at which venipuncture is performed.
The outpatient setting: Where alternative sampling might be most feasible
Not all venous blood draws will be suitable for replacement by self-sampling. For example, emergency care, inpatient monitoring, and tests requiring large blood volumes or immediate processing will likely be unsuitable for unsupervised self-sampling. However, a substantial share of the 1.4 billion venipunctures performed annually in the United States take place in outpatient settings. For example, chronic conditions such as diabetes, cardiovascular disease, kidney disease, endocrine disorders, and inflammatory conditions usually rely on repeat blood testing over long periods of time without patient hospitalization.
Outpatient samples are typically scheduled, are non-urgent, and collected during short clinic visits that take place primarily for the purpose of collecting the blood sample. For these reasons, outpatient settings may represent the most obvious context in which to consider replacing selected venous blood draws with volumetric self-sampling. Because outpatient blood draws depend on staffed clinic visits and trained phlebotomists, replacing a portion of these visits with home-based sampling could have a meaningful impact on overall cost.
So, how much can be saved?
Increased accessibility to diagnosis and earlier intervention
In a Danish pilot study evaluating at-home HbA1c capillary blood self-sampling for type 2 diabetes screening, advancing diagnosis by three years was estimated to generate approximately €1,514 in societal savings per detected case, corresponding to a return on investment of 1.28. This means that for every euro invested in the screening program, society would save €1.28 through reduced treatment costs and productivity losses, as earlier diagnosis lowers the risk of costly diabetes complications (8). While disease models differ across conditions, the principle is the same: when self-sampling lowers barriers to testing, earlier detection may reduce long-term complications and associated costs.
Costs of sample collection and testing workflow
Beyond disease progression, the method of blood collection itself carries economic implications. A cost comparison of conventional venous sampling versus at-home dried microsampling in pediatric therapeutic disease monitoring found total societal costs per sample of €259 for conventional venipuncture versus €102 for home sampling in renal transplant patients (a 61% reduction), and €277 versus €158 in hemato-oncology patients (a 43% reduction). In that study, conducted by researchers in the Netherlands, total costs were calculated from a societal perspective by adding up healthcare costs, patient-related costs and costs related to loss of productivity of the caregiver. The study found that savings were largely driven by reduced travel time and productivity losses rather than laboratory costs alone, and the total savings was dependent upon the number of hospital visits that could be avoided by using home sampling instead of conventional blood sampling (9).
The question of cost is not straightforward as outcomes vary depending on whether the analysis considers only direct healthcare expenditure or takes a broader societal view. For instance, in one modeling study of home-based capillary sampling in chronic care, direct healthcare costs were predicted to increase modestly (+€27.25 per patient per year), while total societal costs were predicted to decrease by €24.86 per patient per year, largely due to reductions in travel time and productivity loss (10).
How sample format influences shipping logistics
Besides the costs addressed above, the physical format of the blood sample can also influence logistics costs in at-home diagnostic programs. Liquid blood samples typically require more restrictive shipping conditions than dried samples, which can affect both packaging options and transportation methods.
Shipping information provided by a U.S.-based diagnostic solutions provider indicates that dried volumetric blood sampling devices can be shipped using lightweight first-class mail packaging, allowing lower outbound postage compared with other bulkier sampling solutions. In contrast, liquid blood collection kits such as microtainer tubes or venous collection supplies generally require more robust packaging and are typically shipped using ground services.
Return shipping requirements may differ even more substantially. Because dried blood samples remain stable at ambient temperature, they can usually be returned to laboratories using standard ground shipping. Liquid samples, on the other hand, are frequently returned using expedited shipping services such as overnight or two-day delivery to meet sample handling requirements. According to indicative shipping estimates provided by the same provider, who wishes to remain anonymous, the ability to use first-class outbound shipping and ground return shipping may reduce outbound postage by approximately 60% and lower return shipping costs by approximately $5–$13 per sample.
Lessons from other screening programs
As mentioned earlier, published economic analyses specific to blood self-sampling remain limited. However, parallels can be drawn from other screening programs, notably the human papilloma virus (HPV) screening programs, where home-based self-collection has been evaluated on a national level. In Sweden, transition to home-based vaginal self-sampling for HPV detection was associated with similar clinical effectiveness to clinician-collected cervical sampling and a projected 36% reduction in screening costs (11). In England, a study to model HPV self-sampling estimated an average cost per complete screen of £56.81 for clinician-collected cervical sampling compared with £40.37 for vaginal self-sampling, representing approximately a 30% reduction in cost (12).
Although HPV screening differs clinically from blood-based diagnostics, these analyses illustrate how shifting sample collection from clinic-based to home-based methods can change the overall cost structure of large-scale testing programs.
References:
1. Fredolini C, Dodig-Crnković T, Bendes A, Dahl L, Dale M, Albrecht V, et al. Proteome profiling of home-sampled dried blood spots reveals proteins of SARS-CoV-2 infections. Communications medicine. 2024 Dec 1;4(1). doi:10.1038/s43856-024-00480-4 PubMed PMID: 38565620.
2. Rollborn N, Åkerfeldt T, Nordin G, Xu XY, Mandic-Havelka A, Hansson LO, et al. Analysis of HbA1c on an automated multicapillary zone electrophoresis system. Scand J Clin Lab Invest. 2017 Jan 2;77(1):15–8. doi:10.1080/00365513.2016.1238507 PubMed PMID: 27768851.
3. Guterstam J, Tavic C, Barosso M, Beck O. A multicomponent LC-MS/MS method for drugs of abuse testing using volumetric DBS and a clinical evaluation by comparison with urine. J Pharm Biomed Anal. 2024 Jun 15;243(8):116075. doi:10.1016/j.jpba.2024.116075 PubMed PMID: 38457867.
4. Vethe NT, Åsberg A, Andersen AM, Heier Skauby R, Bergan S, Midtvedt K. Clinical performance of volumetric finger-prick sampling for the monitoring of tacrolimus, creatinine and haemoglobin in kidney transplant recipients. Br J Clin Pharmacol. 2023 Dec 1;89(12):3690–701. doi:10.1111/bcp.15870 PubMed PMID: 37537150.
5. Rui P KKAJJ. National Hospital Ambulatory Medical Care Survey: 2016 emergency department summary tables. 2016. Available from: [Internet]. 2016 [cited 2026 Feb 18]. Available from: https://archive.cdc.gov/www_cdc_gov/nchs/data/nhamcs/web_tables/2016_ed_web_tables.pdf
6. Alexandrou E, Ray-Barruel G, Carr PJ, Frost S, Inwood S, Higgins N, et al. International prevalence of the use of peripheral intravenous catheters. J Hosp Med. 2015 Aug 1;10(8):530–3. doi:10.1002/jhm.2389 PubMed PMID: 26041384.
7. Leipheimer JM, Balter ML, Chen AI, Pantin EJ, Davidovich AE, Labazzo KS, et al. First-in-human evaluation of a hand-held automated venipuncture device for rapid venous blood draws. Technology (Singap World Sci). 2020 Sep;7(3–4):98. doi:10.1142/s2339547819500067 PubMed PMID: 32292800.
8. Mateu NC, Rossing P, Neergaard KP, Thybo T. Feasibility and cost-effectiveness of at-home self-sampling screening for type 2 diabetes: a pilot screening study in Denmark. BMJ Open Diabetes Res Care. 2026 Feb 11;14(1):5539. doi:10.1136/bmjdrc-2025-005539 PubMed PMID: 41672578.
9. Martial LC, Aarnoutse RE, Schreuder MF, Henriet SS, Brüggemann RJM, Joor MA. Cost Evaluation of Dried Blood Spot Home Sampling as Compared to Conventional Sampling for Therapeutic Drug Monitoring in Children. PLoS One. 2016 Dec 1;11(12):e0167433. doi:10.1371/journal.pone.0167433 PubMed PMID: 27941974.
10. Lingervelder D, Kip MMA, Wiese ED, Koffijberg H, Ijzerman MJ, Kusters R. The societal impact of implementing an at-home blood sampling device for chronic care patients: patient preferences and cost impact. BMC Health Services Research 2022 22:1. 2022 Dec 15;22(1):1529-. doi:10.1186/s12913-022-08782-w PubMed PMID: 36522664.
11. Ellinor Östensson A, Borgfeldt C, Pedersen K, Hellman K, Sy S, Lei J, et al. Cost-effectiveness of human papillomavirus self-sampling in the Swedish cervical screening program. medRxiv. 2025 Feb 13;2025.02.12.25322120. doi:10.1101/2025.02.12.25322120
12. Huntington S, Puri Sudhir K, Schneider V, Sargent A, Turner K, Crosbie EJ, et al. Two self-sampling strategies for HPV primary cervical cancer screening compared with clinician-collected sampling: an economic evaluation. BMJ Open. 2023 Jun 6;13(6). doi:10.1136/bmjopen-2022-068940 PubMed PMID: 37280031.