Most American homes are not roughed in for a toilet like that. The waste pipe will be in the floor, about 12 to 14 inches from the wall. So installing one of th

Most American homes are not roughed in for a toilet like that. The waste pipe will be in the floor, about 12 to 14 inches from the wall. So installing one of these in an existing home is going to require changing both your water and waste plumbing and opening a pretty big hole in the floor and the wall to get at all of that. Additionally this is about 6x the price of a standard toilet. Not too surprising why they aren't that common.