Prices of DME are almost laughable (from a consumer's point of view). OTOH, you don't see these companies in the "Fortune 100"!

I've been trying to understand the factors that go into these prices -- with an eye towards maybe seeing if there are ways to avoid some of those issues.

My short list, thus far:
  • the products aren't commodities (in the same sort of quantities that other commodities are)
  • there is a fair bit of "selling cost" (interacting with customer)
  • there is a fair bit of purchasing cost (interacting with insurers on behalf of customer)
  • there are subsidies in effect (which seem to drive up the price of whatever is subsidized)
  • they are physically large (more space on showroom floor)
  • they need to be "tried on" (can't just buy out of a catalog and return it if you don't like it, like a pair of pants)

Anything else I should add? How do you suppose they "rank" in terms of their (increased) impact on prices?

And, more importantly, how can these be minimized?