The SenSura Mio Click drainable pouch represents Coloplast's mechanical coupling alternative to the Flex soft-adhesive system, providing the audible "click" confirmation that many users prefer for psychological security and attachment verification. The rigid snap-together coupling appeals to patients who value tangible, audible feedback over the silent attachment of flexible systems, particularly those with vision impairment or reduced tactile sensitivity who benefit from hearing the secure connection.

The 60mm flange size serves a critical underserved market segment: patients with large-diameter stomas (typically 50-60mm) resulting from stoma prolapse, parastomal hernias, post-operative edema, bariatric surgery complications, or revision surgeries. While standard 50mm flanges accommodate 40-45% of the ostomy population, the 60mm size specifically serves the 20-25% of patients whose larger stomas cannot be adequately managed with standard sizing—a population often frustrated by limited product availability and chronic leakage from undersized equipment.

The Maxi capacity designation indicates this pouch is designed for high-volume output situations, providing significantly more capacity than standard pouches (typically 350-400mL). Combined with the transparent design and lack of filter, this pouch is purpose-built for liquid output management where traditional filtered pouches would quickly saturate and fail. The absence of a filter is an intentional design feature rather than a limitation: filters become non-functional within hours when exposed to liquid ileostomy output, leading to premature pouch ballooning. By eliminating the filter entirely, this pouch provides reliable, predictable performance for liquid-output patients who would otherwise experience frequent filter failure.

The transparent body allows continuous visual monitoring of output volume, consistency, and color—essential for post-operative assessment, ileostomy management, clinical evaluation in healthcare settings, and early detection of complications like bleeding, obstruction, or infection. Healthcare professionals prefer transparent pouches for the first 4-8 weeks post-surgery when monitoring is critical, and many patients continue using transparent pouches long-term for the peace of mind of being able to visually assess their stoma function without pouch removal.

The soft grey textile backing creates a non-clinical appearance while providing quiet, rustle-free movement—important for professional and social situations. The wide drain outlet facilitates quick, hygienic emptying of liquid output without splashing or mess, and the large opening prevents clogs from thicker output that might occasionally occur.

---

Key Features & Benefits

Click Mechanical Coupling System

✓ Rigid snap-together coupling with audible "click" confirmation
✓ Provides tangible, audible feedback of secure attachment (vs. silent Flex system)
✓ Preferred by 35-40% of ostomy users (particularly vision-impaired, elderly)
✓ Visual verification of secure connection (see the snap engaged)
✓ Tactile confirmation when pressing coupling together
✓ Psychological security from hearing/feeling the lock engage

60mm Large Flange Size - Underserved Market

✓ Serves patients with large stomas (50-60mm diameter)
✓ 20-25% of ostomy population requires large flanges (100,000-125,000 Canadian patients)
✓ Most suppliers don't stock 60mm = competitive monopoly opportunity
✓ Essential for: Stoma prolapse, parastomal hernias, post-op edema, bariatric patients, revision surgeries
✓ Eliminates chronic leakage from undersized standard equipment
✓ High patient loyalty (large-stoma patients MUST buy from suppliers who stock 60mm)

Maxi Capacity for High-Output Management

✓ Significantly larger than standard pouches (350-400mL)
✓ Reduces emptying frequency from 6-8× to 4-5× daily
✓ Ideal for ileostomy (liquid output 800-1500mL daily)
✓ Accommodates high-output episodes (illness, dietary changes, medication effects)
✓ Extended capacity reduces urgency and public restroom visits
✓ Can handle overnight filling without leakage risk

Transparent Design for Clinical Monitoring

✓ Full visibility of output volume, consistency, and color
✓ Essential post-operative monitoring (first 4-8 weeks standard protocol)
✓ Early detection of bleeding, obstruction, or unusual output
✓ Healthcare professional assessment without pouch removal
✓ Patient self-monitoring and peace of mind
✓ Accurate output measurement for medical records

No Filter Design - Intentional for Liquid Output

✓ Eliminates filter saturation issues common with liquid output
✓ Filters become non-functional within 4-8 hours with ileostomy output
✓ No false sense of security from failed filters
✓ Predictable, reliable performance without filter-related ballooning
✓ Patients can "burp" pouch manually when needed (break coupling seal briefly to release gas)
✓ Reduces product failures and patient frustration

Wide Drain Outlet for Easy Emptying

✓ Large opening accommodates liquid and semi-formed output
✓ Quick drainage without splashing or mess
✓ Prevents clogs from thicker output
✓ Easy to clean between empties (rinse interior if desired)
✓ Secure closure mechanism prevents leakage
✓ Compatible with night drainage bags for continuous 24-hour drainage

Soft Grey Textile Backing

✓ Quiet, rustle-free movement (no plastic crinkling sounds)
✓ Non-clinical appearance (neutral grey, not hospital white)
✓ Comfortable against clothing
✓ Discreet in professional and social situations
✓ Textile absorbs minor condensation (reduces slippage under clothing)

2-Piece System Advantages

✓ Change pouches 4-8× daily without disturbing skin barrier
✓ Skin barrier remains 3-5 days (reduced trauma frequency)
✓ More economical for frequent changes (reuse barrier multiple days)
✓ Easier stoma inspection (remove pouch temporarily, barrier stays)
✓ Switch pouch types on same barrier (transparent to opaque, standard to maxi)

---

Clinical Applications

Primary Applications:

✓ Large-Diameter Stoma Management (50-60mm)
The 60mm flange is specifically designed for patients whose stomas cannot be adequately fitted with standard 50mm flanges. This includes stoma prolapse (stoma extends further than normal, appearing larger), parastomal hernias (bulging around stoma creating larger circumference), post-operative edema (temporary swelling in first 8-12 weeks), bariatric patients (larger body habitus often correlates with larger stomas), and revision surgeries where previous stoma complications led to creation of larger opening.

✓ Ileostomy with Liquid Output
Ileostomy output is consistently liquid-to-paste consistency due to removal of the colon's water absorption capacity. Daily output typically ranges from 800-1500mL, requiring high-capacity pouches to minimize emptying frequency. The lack of filter is essential—liquid output saturates standard filters within 4-8 hours, causing premature ballooning and filter failure. The transparent design allows monitoring of the characteristic greenish-brown to yellow-brown liquid output for volume assessment and consistency changes.

✓ High-Output Situations (>1200mL Daily)
Any condition causing increased intestinal output benefits from maxi-capacity pouches. This includes short bowel syndrome, gastroenteritis, dietary indiscretion, medication effects (antibiotics, chemotherapy, laxatives), inflammatory bowel disease flares, and intestinal infections. High-output episodes may be temporary (illness, treatment side effects) or permanent (short bowel syndrome), and the maxi capacity reduces the burden of constant emptying.

✓ Post-Operative Monitoring (First 4-8 Weeks)
Hospital protocols typically require transparent pouches immediately post-surgery to allow surgical teams to monitor output characteristics without pouch removal. The 60mm flange accommodates initial post-operative stoma edema (swelling), which can make stomas appear significantly larger in the first 2-3 months before settling to permanent size. Transparent pouches enable assessment of output volume, consistency, color, and detection of complications like bleeding or obstruction.

✓ Patients Who Experience Filter Failure
Patients frustrated by constant filter saturation and pouch ballooning are ideal candidates for unfiltered pouches. Many ileostomy patients report that standard filtered pouches balloon within half a day, requiring frequent "burping" (manually releasing gas) or premature pouch changes. The honest design of this unfiltered pouch eliminates the disappointment of non-functional filters.

✓ Clinical Assessment in Healthcare Settings
Hospitals, long-term care facilities, and home care agencies prefer transparent pouches for visual assessment during patient monitoring. The 60mm size accommodates a broader range of stoma presentations than standard 50mm, reducing the need to stock multiple sizes. Healthcare professionals can assess stoma health, output characteristics, and proper fit through the transparent window without disturbing the barrier or exposing the patient.

✓ Night Drainage System Integration
The wide drain outlet connects seamlessly to night drainage bags for continuous 24-hour drainage. This is essential for very high output situations (>2000mL daily), short bowel syndrome, or patients who prefer uninterrupted sleep. The maxi capacity also allows overnight use without night drainage connection for moderate output (800-1200mL).

Specific Patient Populations:

✓ Stoma Prolapse Patients
Prolapse causes the intestine to protrude further through the abdominal wall, creating a larger effective stoma diameter. The 60mm flange accommodates this increased size, preventing undermining and leakage common with standard sizes.

✓ Parastomal Hernia Patients
Hernias around the stoma create bulging and irregular contours, often requiring larger flanges to capture the entire area and prevent leakage at edges. The 60mm size provides adequate coverage for hernia-related stoma enlargement.

✓ Bariatric Surgery + Ostomy Patients
Patients with higher BMI often have larger stomas, and the 60mm flange serves this population that is chronically underserved by standard 50mm products. The combination of larger stoma size and potentially higher output (malabsorption from bariatric procedures) makes this product essential.

✓ Revision Surgery Patients
Patients who've had multiple ostomy surgeries or complications often end up with larger or irregularly shaped stomas. The 60mm flange provides the extra coverage needed for complex stoma presentations.

✓ New Ileostomy Patients (First 3-6 Months)
Initial post-operative edema makes stomas appear larger than their permanent size. The 60mm flange accommodates this temporary enlargement during the adaptation period, then patients may transition to 50mm once swelling resolves.

✓ Short Bowel Syndrome
Permanent high liquid output requires unfiltered, high-capacity pouches. The 60mm size often serves this population who frequently have complex surgical histories and larger stomas.

✓ Chemotherapy/Radiation Patients
Treatment side effects cause liquid output and may create stoma size changes. The transparent design allows monitoring during treatment, and the large capacity handles increased output.

✓ Institutional Patients (Nursing Homes, Hospitals)
The 60mm size reduces fitting errors by nursing staff, and the transparent design allows assessment during routine care. The unfiltered design eliminates confusion about filter saturation.

---

Technical Specifications

Product Details:

• Brand: Coloplast
• Product Line: SenSura Mio Click
• System Type: 2-Piece Drainable Pouch
• Coupling Type: Click (Mechanical Snap-Lock)
• Coupling Size: 60mm (Red Color-Coding)
• Pouch Capacity: Maxi (High-Output)
• Transparency: Transparent (Clear Body)
• Filter: None (Unfiltered Design)
• Backing Material: Soft Neutral-Grey Textile Cover
• Drain Outlet: Wide Opening with Integrated Closure
• Original Packaging: 10 Pouches per Box
• Unit Sold: Single Pouch (Individual Unit)

Material Composition:

• Pouch Film: Medical-grade transparent plastic (multilayer barrier film)
• Backing: Soft textile fabric (neutral grey, non-woven material)
• Coupling Ring: Rigid plastic mechanical coupling (red 60mm)
• Filter: None (intentionally unfiltered)
• Outlet Closure: Integrated clamp, Velcro, or fold-up system (varies by specific SKU)

Dimensions & Capacity:

• Coupling Diameter: 60mm (Red color-coding)
• Pouch Length: Approximately 300-350mm (Maxi size)
• Pouch Width: Approximately 150-200mm at widest point
• Capacity: Maxi designation (significantly exceeds standard 350-400mL, typically 500-700mL)
• Drain Outlet Width: Wide opening (approximately 30-40mm for fast drainage)

Coupling System:

• Type: Click mechanical snap-lock
• Attachment: Press coupling rings together, hear/feel "click"
• Detachment: Squeeze release tabs on sides, pull apart
• Audible Confirmation: Yes (distinct clicking sound when secure)
• Visual Confirmation: Yes (can see coupling engaged)
• Tactile Confirmation: Yes (feel snap-lock engage)

Compatibility Requirements:

• Required Baseplate: SenSura Mio Click 60mm Skin Barrier (Red Coupling)
• NOT Compatible With: Flex coupling baseplates (soft adhesive system)
• NOT Compatible With: Other flange sizes (50mm, 40mm, 70mm)
• Brand Specific: Only Coloplast SenSura Mio Click baseplates work
• Night Bag Connection: Compatible with standard urostomy night drainage bags

Performance Characteristics:

• Wear Time: Typically 1-2 days per pouch (empty multiple times, reuse)
• Emptying Frequency: 4-5 times daily with high output (vs. 6-8× with standard capacity)
• Filter Lifespan: N/A (intentionally unfiltered)
• Temperature Tolerance: Stable 15-40°C (59-104°F)
• Water Resistance: Fully waterproof (shower, bath, swim capable)
• Activity Level: Suitable for all activity levels (secure Click coupling)

Color Coding System:

• Red Coupling Ring: Indicates 60mm flange size
• Coloplast Standard: Red = 60mm, Purple = 70mm, Green = 40mm, Blue = 50mm
• Universal Identification: Color prevents incorrect baseplate/pouch matching

Regulatory & Safety:

• Medical Device Classification: Class II Medical Device
• Regulatory Compliance: Health Canada Licensed, FDA Cleared (510(k))
• Latex Content: Latex-Free (safe for latex allergies)
• Sterilization: Not sterile (clean technique for application)
• Shelf Life: 3-5 years from manufacture date
• Storage: Cool, dry place away from direct sunlight

Stoma Compatibility:

• Baseplate Opening Range: 60mm baseplates typically available with stoma openings 45-60mm
• Ideal Stoma Diameter: 50-60mm (large stomas)
• Stoma Protrusion: All types (flush, level, protruding)
• Output Type: All types, but specifically designed for liquid output

---

Usage Instructions

Initial Setup (First-Time Application)

1. Baseplate Must Be Applied First (Sold Separately)

• This pouch attaches to a 60mm SenSura Mio Click skin barrier (baseplate)
• If no barrier is currently in place, apply one first and allow 2-3 minutes to adhere
• Verify you have a RED 60mm Click baseplate (red = 60mm, must match pouch)
• Click system ≠ Flex system (not interchangeable—must match coupling types)

2. Verify Pouch Drain is Closed

• Check that drain outlet is fully closed and secure before attachment
• Some models have integrated clamps, others Velcro or fold-up closures
• An open drain will leak immediately upon attachment
• Practice closing mechanism several times before first use

3. Attach Pouch to Baseplate Using Click System

• Hold pouch at top center with coupling ring facing the baseplate
• Align the red coupling ring of pouch with red ring on baseplate
• Position coupling rings directly over each other (concentric circles)
• Press firmly together starting at top (12 o'clock position)
• Work around the circle, pressing until you hear CLICK sound
• The audible click confirms secure attachment
• Visually verify coupling is engaged all around (360 degrees)
• Gently tug pouch to confirm it won't separate

4. Initial Inspection

• Verify click engagement is complete around entire circumference
• Check that drain outlet remains closed
• Look through transparent pouch to confirm stoma is visible
• Pouch should hang naturally without pulling or tension

Daily Pouch Management

Emptying the Pouch (4-5 Times Daily for High Output):

1. Timing:
   • Empty when pouch is 1/3 to 1/2 full (approximately 250-350mL)
   • Don't wait until completely full (strain on coupling, leak risk)
   • Typical schedule: Upon waking, mid-morning, afternoon, evening, before bed
2. Positioning:
   • Sit on toilet with pouch between legs, or stand and lean forward over toilet
   • Support baseplate with one hand (prevents skin pulling)
   • Hold drain outlet with other hand
3. Opening Drain:
   • Release closure mechanism (clamp, Velcro, or fold)
   • Control opening—don't let it spring open suddenly
   • Direct outlet into toilet bowl
   • Wide outlet allows fast drainage
4. Emptying:
   • Allow contents to drain completely under gravity
   • Gently squeeze pouch from top to bottom to express all contents
   • Wide outlet enables quick, complete drainage with minimal residue
5. Cleaning Outlet:
   • Wipe inside and outside of outlet with toilet paper
   • Some users rinse interior: fill with water, swish, drain
   • Dry outlet thoroughly before closing
   • Clean outlet = better seal, less leakage
6. Closing Drain:
   • Close outlet securely
   • Double-check closure is complete (most common leak source)
   • Fold closed outlet upward and secure with tab/clip if provided

Managing Unfiltered Pouch (Gas Buildup):

Since this pouch has NO FILTER, gas accumulation is normal and expected:

• "Burping" the Pouch:
  • When pouch balloons with gas: Squeeze release tabs on coupling
  • Slightly separate coupling (just enough to release gas—don't remove pouch)
  • Allow gas to escape
  • Press coupling back together until CLICK heard
  • This takes 5-10 seconds and prevents uncomfortable ballooning
• Frequency:
  • May need to burp 2-4 times daily depending on diet and output
  • High-fiber foods, carbonated drinks, chewing gum increase gas
  • After meals is common burping time
• Alternative:
  • Some users prefer to briefly detach and reattach pouch entirely
  • Remove pouch (squeeze tabs, pull apart)
  • Allow gas to escape from stoma
  • Reattach pouch (press until CLICK)

Monitoring Output Through Transparent Pouch:

• Volume Assessment: Clear visibility allows estimation of output volume
• Consistency Check: Monitor for changes (more liquid, thickening, particles)
• Color Observation: Normal ileostomy = greenish-brown to yellow-brown
• Blood Detection: Small amounts = red streaks; large amounts = medical attention
• Abnormalities: Undigested food, unusual colors, excessive mucus, foul odor

When to Change the Pouch:

• Recommended Wear Time: 1-2 days per pouch (empty multiple times, reuse same pouch)
• Change Sooner If:
  • Outlet becomes difficult to clean despite thorough rinsing
  • Pouch develops persistent odor
  • Coupling shows signs of weakening
  • Pouch material becomes cloudy or stained
  • Click coupling won't engage properly

Daily Inspection Checklist: ✓ Click coupling secure all around (no gaps)
✓ Drain outlet closed securely
✓ No leakage at outlet or coupling
✓ Pouch not overly full (empty when 1/3-1/2 full)
✓ Stoma appears healthy through transparent window
✓ Peristomal skin visible through coupling (check for redness)
✓ Burp pouch if balloons with gas

Pouch Removal & Replacement

Removing the Used Pouch:

1. Prepare Replacement:
   • Have new pouch ready before removing old one
   • Verify drain is closed on new pouch
   • Reduces time stoma is uncovered
2. Empty Old Pouch:
   • Always empty completely before removal
   • Minimizes mess and weight
3. Click System Removal:
   • Locate release tabs on sides of coupling (usually two tabs)
   • Squeeze both tabs simultaneously
   • While squeezing, gently pull pouch away from baseplate
   • The Click coupling releases easily when tabs are pressed
   • No need to twist or force
4. Clean the Baseplate Coupling:
   • Wipe baseplate coupling ring with dry tissue
   • Remove any stool residue from coupling area
   • Ensure coupling ring is dry before attaching new pouch
   • If stoma is active, use gauze to catch output temporarily

Attaching the New Pouch:

1. Verify drain closed on new pouch
2. Align red 60mm coupling rings (pouch to baseplate)
3. Press together starting at top, work around circle
4. Listen for CLICK—audible confirmation essential
5. Visual check: verify coupling engaged 360 degrees
6. Tug test: gentle pull to confirm secure attachment

Disposal:

• Empty pouch contents into toilet
• Seal pouch in disposal bag (opaque, odor-proof)
• Dispose in regular household trash (not recyclable)
• Never flush the pouch—will clog plumbing

Connecting to Night Drainage Bag

When to Use Night Drainage:

• Very High Output: >1500-2000mL daily output
• Nighttime Leaks: Pouch overfills during sleep despite maxi capacity
• Short Bowel Syndrome: Continuous drainage needs
• Uninterrupted Sleep: Eliminates nighttime wakings to empty pouch

Connection Process:

1. Select Compatible Night Bag:
   • Standard 2-liter urostomy night drainage bags
   • Verify adapter fits pouch outlet (most universal)
2. Prepare Before Bed:
   • Empty pouch completely
   • Position night bag lower than body (gravity drainage)
   • Hang from bed frame or place in container on floor
3. Attach Tubing:
   • Open pouch drain outlet
   • Insert night bag adapter into pouch outlet
   • Twist-lock or push-fit connection (depends on system)
   • Ensure secure—test by gentle tugging
4. Verify Flow:
   • Watch for initial drainage into night bag
   • Confirms connection is open and working
   • Adjust tubing if flow blocked
5. Morning Disconnection:
   • Disconnect tubing from pouch
   • Close pouch drain immediately
   • Empty night bag into toilet
   • Rinse if reusable, discard if disposable

Troubleshooting Common Issues

Problem: Gas Ballooning (Expected with Unfiltered Pouch)

This is Normal: Unfiltered pouches balloon with intestinal gas—this is expected behavior, not a defect.

Solutions:

• "Burp" pouch 2-4× daily (squeeze coupling tabs, release gas, re-click)
• Reduce gas-producing foods (beans, carbonated drinks, cruciferous vegetables, chewing gum)
• Take simethicone or activated charcoal supplements (consult healthcare provider)
• Accept ballooning as normal—unfiltered design trades filter saturation for occasional burping

Problem: Click Coupling Won't Engage (No Audible Click)

Causes:

• Output residue on coupling rings
• Misalignment of coupling rings
• Damaged or deformed coupling
• Wrong coupling type (Click pouch on Flex baseplate, or vice versa)

Solutions:

• Clean both coupling rings thoroughly with dry tissue
• Verify you have matching Click systems (not Click pouch on Flex baseplate)
• Align rings carefully—red to red, concentric circles
• Press firmly starting at top, work around entire circle
• If coupling is damaged, replace baseplate or pouch
• If no click after proper alignment, coupling may be incompatible or defective

Problem: Outlet Leakage Despite Closed Clamp

Causes:

• Outlet not fully cleaned before closing
• Residue prevents proper seal
• Closure mechanism worn or damaged

Solutions:

• Thoroughly wipe outlet inside and outside (multiple passes)
• Rinse pouch interior with water after emptying
• Dry outlet completely before closing
• Check closure mechanism—ensure fully engaged
• Replace pouch if outlet material degraded

Problem: Coupling Separation During Activity

Causes:

• Pouch overfilling (weight strains coupling)
• Coupling not fully clicked during attachment
• Damaged coupling components

Solutions:

• Empty pouch more frequently (don't exceed 1/2 full)
• Support pouch with hand during vigorous activity
• Verify "click" heard/felt during every attachment
• Check coupling for damage or wear
• Consider ostomy belt for additional support during high-impact activities

Problem: Difficulty Seeing Through Transparent Pouch

Causes:

• Stool residue coating interior
• Pouch film becoming cloudy over time

Solutions:

• Rinse pouch after each emptying (fill with water, swish, drain)
• Use pouch deodorizers with lubricants (improves clarity)
• Change pouch every 1-2 days (cloudiness is normal wear indicator)
• This signals it's time for new pouch

Problem: Large Flange (60mm) Still Leaks

Causes:

• Stoma diameter exceeds 60mm (may need 70mm or custom)
• Irregular stoma shape creating gaps
• Skin folds or creases preventing flat seal

Solutions:

• Remeasure stoma—if >65mm, may need 70mm flange or cut-to-fit
• Use barrier paste to fill irregular areas before barrier application
• Use barrier strips in skin folds/creases
• Consult ET nurse if standard products don't achieve seal

Problem: Wide Drain Outlet Difficult to Close

Causes:

• Stool residue in closure mechanism
• Outlet material stiffening

Solutions:

• Clean closure area thoroughly after each emptying
• Apply small amount of water-soluble lubricant to closure
• Avoid petroleum-based products (damage pouch materials)
• Replace pouch if outlet permanently stiff or cracked

---

Strategic Product Positioning

Market Analysis

Target Patient Population:

Primary Market Segment - Large Stoma (60mm Flange):

• Total Canadian Ostomy Patients: 600,000
• Large Stoma Prevalence: 20-25% require 60mm or larger flanges
• Total 60mm Market: 120,000-150,000 patients
• Current Unmet Need: Most suppliers don't stock 60mm (inventory challenge for low-volume items)

60mm Requirement Breakdown:

• Stoma prolapse: 30,000-40,000 patients
• Parastomal hernias: 40,000-50,000 patients
• Bariatric + ostomy: 20,000-25,000 patients
• Post-op edema (temporary): 15,000-20,000 patients annually
• Revision surgeries: 10,000-15,000 patients
• Other large stomas: 5,000-10,000 patients

Coloplast Brand Users:

• Market Share: Coloplast holds 35-40% of global ostomy market
• Canadian Coloplast Users: 210,000-240,000 patients
• 60mm Coloplast Users: 42,000-60,000 patients (20-25% of Coloplast users)

Geographic Considerations:

• Northern Alberta: Edmonton metro = 1.5M population
• Regional Ostomy Patients: 4,500-6,000 total
• 60mm Need: 900-1,500 patients (20-25%)
• Coloplast Users: 315-600 regional patients (35-40% brand loyalty)

Competitive Landscape

60mm Flange Market - CRITICAL COMPETITIVE GAP:

Market Reality: Most ostomy suppliers DO NOT stock 60mm flanges due to:

1. Lower volume vs. standard 50mm (20-25% vs. 40-45% of patients)
2. Slower inventory turnover
3. Space constraints in retail locations
4. Focus on high-volume products

Result: Patients with large stomas experience chronic product unavailability, forcing them to:

• Order from specialty suppliers (delays, shipping costs)
• Use undersized 50mm equipment (chronic leakage, skin damage)
• Cut oversized holes in cut-to-fit barriers (inconsistent, time-consuming)
• Switch brands based solely on availability rather than preference

OUR COMPETITIVE ADVANTAGE: Stocking 60mm Coloplast products creates a MONOPOLY POSITION in local market:

• Desperate patient population (chronic leakage from undersized products)
• Limited alternatives (few suppliers stock large flanges locally)
• High switching costs (insurance authorization, learning new products)
• Premium pricing power (10-15% higher margins justified by availability)
• Exceptional customer loyalty (patients can't leave—we're their only source)

Direct Competitors (Limited):

1. Specialty Online Ostomy Suppliers:
   • Ship 60mm products nationally
   • 3-7 day delivery times (vs. our same-day availability)
   • Shipping costs ($10-25 per order)
   • Our counter: Immediate availability, in-person fitting, emergency same-day delivery
2. Hospital Pharmacies:
   • Limited selection (usually one brand, if any 60mm)
   • Higher prices (hospital markup)
   • Poor service (no fittings, limited knowledge)
   • Our counter: Complete product line, professional fittings, education
3. Other Local Medical Supply Stores:
   • May stock Hollister or ConvaTec 60mm (different brand)
   • Likely don't stock Coloplast 60mm (we capture Coloplast-loyal patients)
   • Our counter: Multi-brand strategy (stock both Coloplast AND Hollister 60mm)

Click vs. Flex Coupling Competition (Within Coloplast):

Click System (This Product):

• 35-40% of Coloplast users prefer Click
• Audible/tactile confirmation appeals to: elderly, vision-impaired, security-focused users
• Perceived as "more secure" (psychological benefit of hearing click)

Flex System (Soft Adhesive):

• 60-65% of Coloplast users prefer Flex
• Quieter, more comfortable (no rigid plastic coupling)
• Appeals to: younger users, body-conscious users, comfort-focused

Strategic Implication: Stock BOTH Click and Flex systems in 60mm to capture 100% of Coloplast's 60mm market (not just 35-40%)

Competitive Advantages:

1. Local Availability of Rare Size:
   • Only supplier in Edmonton stocking 60mm regularly
   • Eliminates patient frustration from chronic unavailability
   • Patients will drive 30-60 minutes for reliable 60mm supply
2. Complete Coloplast 60mm Portfolio:
   • Click AND Flex coupling systems
   • Transparent AND opaque pouches
   • Filtered AND unfiltered variants
   • Drainable AND closed-end types
   • Captures 100% of Coloplast 60mm market vs. competitors with partial selection
3. Professional Fitting Expertise:
   • Large stomas often have complex presentations (prolapse, hernias, irregular shapes)
   • Expert fitting prevents chronic leakage
   • Most suppliers lack this expertise
4. Insurance Billing Support:
   • AADL/NIHB direct billing
   • Pre-authorization assistance
   • Reduces patient out-of-pocket burden

Revenue & Pricing Analysis

Pricing Structure:

• Retail Price per Pouch: $10-18 CAD (single unit)
• Retail Price per Box (10 pouches): $100-180 CAD
• Wholesale/Volume Pricing: $75-135 per box (25-35% discount)
• 60mm Premium: 10-15% higher than 50mm due to lower volume, higher demand (scarcity pricing)
• Insurance Reimbursement: Typically 75-100% (AADL 75%, NIHB 100%, private 80-100%)

Patient Cost Analysis:

Typical Pouch Consumption (Ileostomy):

• Wear Time: 1-2 days per pouch (empty 4-5× daily, reuse)
• Monthly Usage: 15-30 pouches (1.5-day average = 20 pouches/month)
• Annual Usage: 180-365 pouches

Monthly Patient Spending:

• Pouches Only (Retail): $200-540 monthly (20 pouches × $10-18, or 2 boxes)
• Plus 60mm Baseplates: $80-150 monthly (change every 3-5 days = 6-10 per month)
• Plus Accessories: $30-60 monthly (paste, powder, wipes, disposal bags)
• Total Monthly Spend: $310-750 CAD

Annual Patient Revenue:

Pe