stoma appliances

247 Pages·2016·5.94 MB·English

by  Don Page

STOMA APPLIANCES

STOMA APPLIANCES – REIMBURSEMENT PRICES

Important Notices

1 This list includes those items which may be ordered by authorised prescribers on
the appropriate lists of Health Board, and indicate the specifications and
reimbursement prices which shall apply to the stoma services contractors
(community pharmacy contractors and dispensing appliance contractors) who are
authorised to dispense these lines.

2 Only those stoma appliances in this document shall be supplied and reimbursed

3 This version is dated 1st September 2016

4 Any application for addition, amendment or deletion of lines to this list must be
made in writing to:

Commodity Manager
National Procurement
Gyle Square
EDINBURGH
EH12 9EB

1. Original Belts (Apparatus) are supplied under the Hospital and Specialist
Service.

2. Repairs and replacements may be supplied through the general medical
services.

3. A contractor who will carry out the actual measurement, fitting and supply
of the belt may only accept prescriptions ordering replacement of a
complete Belt (Apparatus).

4. Orders for replacement of "a belt" are to be taken as being for the belt
alone and the prescription referred back to the prescriber to specify order
for a Complete Belt (Apparatus) where such appears to be required.

5. On discharge from hospital, the patient is issued with 2 copies of an
Ostomy Appliance Record Form (a third copy is sent to the patient's
general medical practitioner). The Form details the items that have been
supplied (including code no, size of appliance and unit pack size). The
patient is asked to retain one copy and to give the second copy to his
pharmacist or appliance supplier for future reference.
STOMA APPLIANCES

STOMA APPLIANCES – REIMBURSEMENT PRICES 1
ADHESIVE DISCS/RINGS/PADS/PLASTERS 3
ADHESIVE (PASTES, SPRAYS, SOLUTIONS) 5
ADHESIVE REMOVERS (SPRAYS, LIQUIDS, WIPES) 5
BAG CLOSURES 7
BAG COVERS 8
BELTS 13
COLOSTOMY BAGS 39
COLOSTOMY SETS 85
DEODORANTS 85
DISCHARGE SOLIDIFYING AGENTS 87
FILTERS/BRIDGES 88
FLANGES 89
ILEOSTOMY BAGS 91
IRRIGATION/WASH-OUT APPLIANCES 149
PRESSURE PLATES/SHIELDS 151
SKIN FILLERS AND PROTECTIVES 153
SKIN PROTECTORS 157
STOMA CAPS/DRESSINGS 161
TUBING AND ACCESSORIES STOMA 163
TWO PIECE OSTOMY SYSTEMS 164
UROSTOMY BAGS 220
WOUND MANAGEMENT PRODUCTS 240
STOMA APPLIANCES

ADHESIVE DISCS/RINGS/PADS/PLASTERS Order Price
Manufacturer Appliance No Qty (p)
Bullen CS Ltd. Double Sided Adhesive Plaster
Zinc Oxide
89mm x 89mm UF 33 10 396
102mm x 102mm UF 34 10 489
127mm x 127mm UF 35 10 827
Double Sided Adhesive Plaster
Acrylic base
89mm x 89mm UF 62 10 355
102mm x 102mm UF 63 10 457
127mm x 127mm UF 64 10 769
Flange Retention Strips
102mm x 25mm UF 440 100 354
102mm x 51mm UF 441 100 481
Shelter Safe Seal
Stoma Flange Extender UF7000 40 2150
Clinimed Ltd Hydroframe Flange Extenders
WAF H33 20 (strips) 1315
Hydroframe Mini Flange Extenders
WAF M33 30 (strips) 1004

Hydroframe Flange Extenders with manuka honey
MHWAF H33 20 (strips) 1315
Hydroframe Mini Flange Extenders with manuka honey
MHWAF M33 30 (strips) 1004
CliniSupplies Ltd ZenSetiv Half Moon Strips
Hydrocolloid A2015 20 2200
Microporous A2016 20 2200

Coloplast Ltd Brava Elastic Tape 12070 20 1255
Brava Elastic Tape Belt 12072 20 1315
Brava Elastic Tape Straight 12074 20 1289

Jade-Euro-Med Ltd.
Kidney Seals – Adhesive Flange Retaining Strips
Small WJ250-51-T 10 562
Large WJ250-75-J 10 562
Double Sided Adhesive Discs
76mm diam
19mm opening WJ002-19-R 10 530
25mm opening WJ002-25-L 10 530
90mm diam
32mm opening WJ005-32-V 10 530
38mm opening WJ005-38-J 10 530
Chiron Double-Sided Plasters:
90mm square
19mm opening WJ-010-19N 10 720
35mm opening WJ-010-35L 10 720
102mm square
19mm opening WJ-011-19S 10 827
35mm opening WJ-011-35Q 10 827
127mm square
19mm opening WJ-012-19W 10 912
35mm opening WJ-012-35U 10 912
STOMA APPLIANCES

ADHESIVE DISCS/RINGS/PADS/PLASTERS (Continued
Manufacturer Appliance Order No Qty Price
(p)
Jade-Euro-Med Ltd. Chiron Double-Sided Plasters:
150mm square
19mm opening WJ-013-19B 10 1019
102mm x 76mm
19mm opening WJ-014-19F 10 1019
102mm square
25mm opening WJ-016-25J 10 1019
125mm square
25mm opening WJ-018-01C 10 1117

Oakmed Ltd
Curvies flange extenders CUR001 30 1857

Peak Medical Ltd
Varimate Retention Strips VMT0311 60 3750
Varimate Extra Thin Hydrocolloid Curved VMT 60 2400
Retention Strips CURVE
Pelican Healthcare Ltd
Pelican Contour Flange Extender 130860 30 1995

Prosys International Ltd
AcuBond Strips SB2 30 1776

Respond Healthcare Ltd
OstoMart Astoa Adhesive Flange Extender
Small AFES30 30 1172
Large AFEL30 30 1875
Wide AFEW30 30 1650
OstoMart Ostofix Flange Security Tape
2.5cm x 10cm DGW1 100 415
5cm x 10cm DGW2 100 719
OstoMart OstoFIX40 HydroAV Security Frames DWK40 40 2550
OstoMart Ostofix Forty - security frames DFW3 40 1937
OstoMart Ostofix Eighty - security frames DFW80 80 1904

Salts Healthcare
Transacryl Double Sided Plaster
25mm 833018 10 671
32mm 833019 10 671
38mm 833020 10 671
SecuPlast Circular Plasters
32mm SP32 10 1138
38mm SP38 10 1138
45mm SP45 10 1138
57mm SP57 10 1138
70mm SP70 10 1119
SecuPlast Hydro Aloe SPHA2 30 1293
SecuPlast Hydro Security Strips SPH1 30 1194
Trio Healthcare Ltd
Elite Sting Free Adhesive Remover TR201 50ml spray 698
TR202 30 wipes 1222
Silex Silicone Flange Extender TR1060 20 1289
STOMA APPLIANCES

ADHESIVE (PASTES, SPRAYS, SOLUTIONS) Order Price
Manufacturer No Qty (p)

Hollister Ltd. Medical Adhesive Aerosol 7730 90g 1670

Salts Healthcare Latex Adhesive Solution 833005 28ml 234

ADHESIVE REMOVERS (SPRAYS, LIQUIDS, WIPES)
Manufacturer Appliance Order Qty Pric
e
No (p)

CD Medical Ltd Peel-Easy non sting spray 300714 50ml 710
Peel-Easy Wipes 300715 30 wipes 1166

Clinimed Ltd Appeel No Sting Medical Adhesive 3505 30 wipes 1526
Remover
3500 50ml aerosol 920
Appeel Advance No Sting Medical 3501 50ml aerosol 937
Adhesive Remover
Appeel Hydrosolve Flushable Medical 3506 30 wipes 1539
Adhesive Remover Wipes

Coloplast Ltd Brava Adhesive Remover Spray 12010 50ml 842
Brava Adhesive Remover Wipes 12011 30 wipes 1396

ConvaTec Ltd ConvaCare Adhesive S208 100 wipes 1718

ConvaTec Niltac Sting Free Medical TR101 50ml aerosol 825
Adhesive Remover
TR102 30 wipes 1368
Dansac Ltd Dansac No Sting Protector Wipes 081-30 30 wipes 2336
(individual sachets)
Dansac No Sting Adhesive Remover 082-01 50ml spray 924
Dansac No Sting Adhesive Remover 082-30 30 wipes 1497
(individual sachets)
Dansac EasiSpray Adhesive Remover 083-01 50ml spray 650

Ecolab Adhesive Remover 3037050 50ml 408

Hollister Ltd. Adapt no-sting Medical Adhesive 7731 76g 1425
Remover
7737 50ml 695
Universal Remover Wipes 7760 50 1356

Medicareplus Medi Lifteez Medical Adhesive 60321 30 1105
International Ltd Remover Wipes
STOMA APPLIANCES
ADHESIVE REMOVERS (SPRAYS, LIQUIDS, WIPES) (continued
Manufacturer Appliance Order No Qty Price (p)
Oakmed Ltd EasyLease No Sting Medical Adhesive Remover
1206 30 wipes 1492
1408 50ml spray 920

Opus Healthcare Ltd Lift Medical Adhesive Remover
5500 30 sachets 885
5501 100ml bottle 624
Lift Plus Citrus Medical Adhesive Remover
5504 30 sachets 1445
5505 50ml spray 880
Lift Plus 360 Citrus Medical Adhesive Remover
5507 50ml spray 640
Lift Plus Medical Adhesive Remover
5502 30sachets 1445
5503 50ml bottle 880
Lift Plus 360 Medical Adhesive Remover
5506 50ml Spray 640
Ultra Cleanse Skin Cleanser
4400 30sachets 868
4401 200ml bottle 1685

Peak Medical Ltd Offmate Stoma Adhesive Remover
OM50 50ml spray 705
Offmate Stoma Adhesive Remover Wipes
OM30 30 wipes 900

Pelican Healthcare Pelican Release Silicone Based Adhesive Remover with added
Ltd. Vitamin E
130360 30 wipes 1549
130460 50ml spray 934

Prosys International Independence RS1 50ml aerosol 709
Ltd Adhesive Remover
Independence No ARW1 30 sachets 1508
Sting Adhesive
Remover Wipes

Respond Healthcare OstoMart OstoClear MRW1 30 sachets 897
Ltd
MRW2 100ml bottle 982
OstoMart OstoPEEL No Sting Medical Adhesive Remover Spray
Apple OPA50 50ml aerosol 649
Blackberry OPB50 50ml aerosol 649
Mint OPM50 50ml aerosol 649
No Fragrance OPN50 50ml aerosol 649
OstoMart OstoPEEL Blackberry No Sting Medical Adhesive
Remover Wipes
OPBW30 30 1060

Salts Healthcare WipeAway Adhesive WA1 30 sachets 899
Wipeaway Plus No Sting Adhesive Remover Spray
WAP 50ml spray 650
Wipeaway Plus No Sting Adhesive Remover
WAP2 30 wipes 865
STOMA APPLIANCES

BAG CLOSURES (Available separately from the bags)
Manufacturer Appliance Order Qty Price
No (p)

C S Bullen Plastic Bag Clamp 400 10 605
Soft Wire Ties 410 50 512

Clinimed Ltd
Closure Clamps (Drainable Bags) 3750 1 122

ConvaTec Ltd. (Beige) (1-piece pouch) S207 10 329
Soft Wire Ties S205 50 569
Curved Clip for Drainable Pouches S202 10 583

Dansac Ltd. Opaque Soft Wire Ties 095-01 50 595
Opaque Longer Soft Wire ties 095-02 50 681

Hollister Ltd Drainable Pouch Clamp Beige 8770 1 125
10 1057

Peak Medical Curved Beige Clip for Drainable CLS10 10 580
Ltd. Pouches

Pelican Healthcare Ltd.
Drainable Pouch Clips 130406 20 728

Salts Closure Clips 833044 5 224
Healthcare
Drainable Pouch Clips CL1 10 782
STOMA APPLIANCES
BAG COVERS

These stoma bag covers can be washed and re-used many times. Cloth fabric *
types are more durable than those made of non-woven fabric /. Refer to the
manufacturer’s instructions.
Manufacturer Appliance Order Qty Price
No (p)

AMI Medical * Suportx Ostomy support bag device with built in
Ltd universal stoma bag holder/cover and night
drainage outlet
Mens Shorts
Black
Small, Medium, Large, X Large, AM11- 1 975
XX Large AM15
Bespoke Size AM16 1 975
Dark Grey Marl
Small, Medium, Large, X Large, AM21- 1 975
XX Large AM25
Bespoke Size AM26 1 975

White
Small, Medium, Large, X Large, AM01- 1 975
XX Large AM05
Bespoke Size AM06 1 975
Mens Fitted Trunks
Black
Small, Medium, Large, X Large, AM61- 1 975
XX Large AM65
Bespoke Size AM66 1 975

Dark Grey Marl
Small, Medium, Large, X Large, AM71- 1 975
XX Large AM75
Bespoke Size AM76 1 975

White
Small, Medium, Large, X Large, AM51- 1 975
XX Large AM55
Bespoke Size AM56 1 975

Bullen CS Ltd. * Night Bag Cover UF 57 1 420
* Day Bag Cover UF 58 1 420

Coloplast Ltd.
* Mini decorated / Open MC2000
White 9013 5 2565
* Uro 2002 4260 White 9014 5 2565
Uro 2002 4241 9016 5 2565
STOMA APPLIANCES
BAG COVERS (continued)
Manufacturer Appliance Order Qty Price
No (p)

Cover Care * Cover Care Pouch Covers
Mini 32/38mm pouches L198 3 772
45/57mm pouches L199 3 772

Standard Drainable pouches and L201 3 817
urostomy pouches

Small 38/45mm closed pouches small
drainable pouches and Combihesive L203 3 817
closed pouches

Medium 57 and 70mm closed pouches L204 3 817

Large urostomy pouches L200 3 817

CUI * Cuiwear Ostomy Support Underwear
International
with built in pouch cover
Ladies CF01-CF57 1 950
Mens CW01-CW15 1 950
CN01-CN15 1 950
with built in pouch cover with night drainage
Ladies Black BS31-BS57 1 950
White BS01-BS27 1 950

* Cuiwear Ostomy Support Trunks
Mens Denim LT16-LT30 1 950
Navy LT01-LT15 1 950

Jade-Euro- * Bag Cover Day Size WN124-01-C 1 1243
Med Ltd.
Night Size WN125-04-N 1 1243
Pelican * Eakin Cotton Bag Covers
Healthcare Size of opening
Ltd. Small 32mm 839030 1 506
45mm 839031 1 506

Large 32mm 839033 1 506
45mm 839034 1 506
64mm 839035 1 506
STOMA APPLIANCES
BAG COVERS (continued)
Manufacturer Appliance Order Qty Price
No (p)
Respond * HiLINE CoverSURE Custom-made Covers
Healthcare White Res C1 1 947
Ltd Stone Res C2 1 947
White/Lace Front Res C3 1 947
Appliance to be stated

HiLINE CoverSURE PLUS Pouch Covers
Leak Resistant and Breathable inner lining
White Custom Made Res C4 3 2350
Beige Custom Made Res C5 3 2350

HiLINE CoverSURE LIGHT Pouch Covers
Peached Cotton with Antimicrobial/Antibacterial finish
White Custom Made Res C6 3 2299
Beige Custom Made Res C7 3 2299
Black Custom Made Res C8 3 2299

Salts * Salts Cotton Bag Cover 833029 1 436
Healthcare Appliance to be stated
/ Non-woven fabric