Australia is home to one of the most generous stoma appliance schemes in the world. Today, in 2025, around 3,500 individual items across 11 product groups are fully subsidized and available through the Australian Stoma Appliance Scheme (SAS). This level of support is a far cry from 60 years ago, when ostomates had to purchase their own appliances and government assistance was virtually non-existent.
To appreciate how far we’ve come, let’s look back at the origins of the SAS and the tireless efforts of those who fought for better quality of life for all Australian ostomates.
The Early Foundations
The roots of the Australian Stoma Appliance Scheme date back to the late 1950s and early 1960s. During this period, the Australian stoma associations had been persistent in lobbying the Commonwealth Government for subsidized ostomy appliances. In 1960, a petition was sent to the then Minister for Health by the Ileostomy Association of NSW (now Ostomy NSW Ltd) requesting that free appliances be made available to Australian ostomates.
This advocacy paid off and in 1962, a small number of pharmaceutical items—such as karaya powder, surgical cement, and silicone creams—became available under the Pharmaceutical Benefits Scheme (PBS). Initially dispensed by pharmacies with a prescription, amendments to Section 100 of the National Health Act (1953) allowed stoma associations to supply these items directly to their members. This set a vital precedent for the arrangement for government-subsidized ostomy appliances to be distributed through peer support stoma associations.
The Push for Full Subsidy
Despite progress, pouches still had to be purchased, so lobbying continued. By the late 1960s, the issue gained political traction, even becoming an election talking point by successive opposition leaders, including Gough Whitlam, who recognized its importance. It wasn’t until 1970 though that real progress was made when the tax deductibility of appliances required for stoma management was announced in the Federal Budget.
In November 1971, the Commonwealth Government announced plans to negotiate fixed wholesale pricing with manufacturers for the pharmaceutical items supplied by stoma associations. Under this arrangement, the Government would reimburse associations at the agreed price, effectively establishing the enduring partnership between manufacturers, the Commonwealth, and stoma associations that continues today.
Despite this progress, the ultimate goal of the stoma associations was full subsidy. With strong support from the Australian and New Zealand Council of Stoma Associations (ANZCSA) and the Australian Association of Stomal Therapy Nurses (AASTN), advocacy intensified. In March 1973, the Commonwealth Government responded by establishing a Working Party on Medical and Surgical Aids and Appliances to review the provision of medical and surgical aids and appliances, including ostomy appliances. In April 1974, the working party recommended full subsidy for all eligible person who needed ostomy appliances.
Success On 17 September 1974, Federal Treasurer Frank Crean announced:
“…it is intended to introduce legislation in 1974–75 to authorise the supply, without charge, of stoma appliances to all persons in the community who need them.”
Success!
Finally, on 1 October 1975, the Stoma Appliance Scheme officially commenced.
While the world has seen extraordinary advancements in technology, healthcare, and logistics over the past 50 years, the fundamental structure of the Australian Stoma Appliance Scheme remains remarkably consistent. Since its inception in 1975, the distribution of SAS appliances has continued through charitable stoma associations, operating under the same collaborative model with the Commonwealth Government and manufacturers. These associations still provide government-subsidised products to members in return for a nominal handling fee—a testament to the enduring success of the original framework.