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Emerging Over-the-Counter Hearing Aids

By: John Rho

Have you ever walked into CVS and seen reading glasses for sale? Perhaps you wear glasses yourself. But have you ever wondered if you needed anything for your hearing?

For a multitude of reasons–say, high costs, appearance, time, or something else entirely–many people have yet to get a pair of hearing aids when they would truly benefit from them. The FDA says 37.5 million Americans have difficulty hearing, but only one in four individuals who need hearing aids have actually tried them. Yet, you might see them wearing reading glasses with no problem, enjoying their Facebook memes for fun; in fact, a whopping 164 million Americans wear glasses, out of 177 million people who need correction.

Why is there such a stark difference between correcting vision problems but leaving hearing problems unchecked? Hearing aids are often hard-to-procure and stigmatized, particularly in comparison to their visual analog. However, this phenomenon may change in the near future with the advent of new legislation. In 2017, the Over-the-Counter Hearing Aid Act was passed, creating the possibility of a new era of hearing aids that would alter how people can treat their own hearing loss. However, due to slow-downs due to events like the pandemic, legislation has stalled until last year. Earlier in 2021, President Biden passed an executive order that singled out hearing aids as a good that consumers are unjustly paying a significant premium to purchase. This executive order has jump-started the process of allowing devices to be considered “hearing aids” by the FDA without requiring a prescription.

Imagine you could just walk into a store, like Best Buy or Walgreens, and pick out a hearing aid of your choice. You could try them out before wearing them, picking the one that is right for you at a fraction of the cost of current alternatives. On average, buying new hearing aids generally ranges from $1,000 to $5,000. It would be like shopping for new sneakers at Foot Locker: you can easily see how they fit, whether they look good on you, and ask employees for some guidance. It would be a radical change from the mandatory visit to a doctor’s office, on top of the chance that insurance fails to cover the full costs of your hearing aids (if one has insurance in the first place).

Plus, hearing loss is a much bigger problem than one might think. Disabling hearing loss leads to lost productivity of $9,100 per American every year. One cost-benefit analysis showed that providing hearing-care services for older adults with hearing aids reduced annual Medicare spending by $2,513 per individual (and hearing care services are not currently covered by Medicare). Another study that looked at the impact of hearing aids on dementia symptoms suggested a 30:1 benefit (based on measuring the quality of life). This same study even suggested that the reduction in symptomatology alone was enough to justify the cost of a typical pair of hearing aids for hearing aid wearers. In fact, 6.6 million Americans with hearing loss do not wear hearing aids at all, often using high costs as a chief reason for this. Given this disparity, I think that there is a need for innovation in the field that should do two main things: make hearing aids cheaper and make them more acceptable for the people who need them.

One way to tackle both at the same time would be via Over-the-Counter hearing aids. By increasing competition in the space (thanks to the removal of the prescription barrier, as well as opening up hearing aids for a much larger audience), costs for the consumer should decrease while also allowing for more hearing aids to be sold all together. This increased quantity should benefit hearing aid firms greatly as well. Specifically, there is a significant level of research and development (R&D) put into hearing aids, considering they are a medical device, but only around 2 million Americans get hearing aids yearly. In turn, this compels manufacturers to keep their prices high in order to cover their high fixed costs, stemming from the research and development, that they cannot otherwise afford due to the low quantity sold yearly. By shifting towards a larger Over-the-Counter Hearing Aid market with much greater demand, firms should benefit greatly from a larger quantity of hearing aids sold. As we might say in an economics class, this is an “economy of scale.”

Several companies like Bose, as well as giants like Apple, are exploring innovation in this new class of hearing aids. But as a whole, the new legislation–which will allow for new Over-the-Counter Hearing Aids to enter the market–has opened a huge opportunity for consumers and firms alike.


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