This topic is about the high costs of ostomy bags around the world and explores why they are so expensive and what can be done to manage these costs. Here are some insights and advice from different countries:

- In the United Kingdom, if you have a medical exemption certificate, the NHS provides unlimited ostomy supplies at no direct cost per box.

- In Australia, paying an annual fee of about AUS $45 allows access to free and plentiful supplies through the national scheme.

- In the Netherlands, a single box of ostomy bags can cost around €90, which is approximately £80.

- In the United States:
1. Supplies are typically purchased through distributors, as direct buying from manufacturers is generally not allowed.
2. Retail mark-ups can be very high, with some items billed at over US $200.
3. Medicare and private insurers often reimburse less than the list price and limit the number of supplies per month, leading some users to stretch their supplies by irrigating.
4. Some people have managed to get free supplies every three months by applying directly to manufacturers, especially if they have a low household income.
5. Community groups like the UOAA and the American Cancer Society can help find donated supplies for those without insurance.
6. Retired military personnel using Tricare-style plans report costs of about US $50 for six months’ worth of supplies.

- In Canada, particularly Ontario:
1. Private workplace insurance costing CAN $150 per month can cover 100% of supplies, but high usage can still lead to costs of about CAN $1,000 per month.
2. The government provides a grant of CAN $600 per year, with some provinces offering CAN $800, but this often leaves families with significant out-of-pocket expenses.

- In the U.S., providers often inflate list prices because insurers only pay a fraction, and the remaining costs are billed to patients, leading to higher premiums.

- For terminology, U.S. insurers and TSA prefer terms like "pouch," "pouching system," "appliance," or "prosthetic rectum" for clarity in reimbursement and transport, as some feel "bag" can sound derogatory.

- A safety note: Ostomy bags or pouches are flammable, so it's important to keep them away from open flames or stovetops.