By Jennifer Allen
June 18, 2004
Hearing loss is as common as dandruff, maybe more so, with nearly 30 million Americans suffering from some form of diminished hearing.
Yet, 80% or more avoid hearing aids for reasons that include embarrassment, disappointment with the amount of relief the product offers, and the expense. In fact, only about one in five people who needs a hearing aid has one, according to Sergei Kochkin, executive director of the Better Hearing Institute in Arlington VA.
This may change as cheaper, more accessible devices become available.
Good thing too, as failing to treat hearing loss can have serious consequences. The National Council on the Aging a few years ago studied 2,300 hearing-impaired adults and found that those with untreated hearing loss were more likely to report depression, anxiety, and paranoia and were less likely to participate in organized social activities, compared to those who wear hearing aids. The study was funded by a trade group, the Hearing Industries Association.
Audiologists' Lobbying Pays Off
Hearing aids have been expensive and hard to get since 1977, when the U.S. Food and Drug Administration (FDA) enacted its Hearing Aid Rule. The rule required that consumers see a physician before buying a hearing aid.
Not surprisingly, this was a direct result of testimony from "audiologists," who warned that consumers would otherwise waste money on hearing aids when their hearing loss actually stemmed from a medical condition such as acoustical nerve tumors, infections, and plain old wax buildup. The rule also created an exception: Adults could bypass a doctor if they signed a waiver acknowledging the dangers of skipping a medical evaluation.
Medical evaluations, fitting sessions (with, who else, audiologists), and the battery of tests preceding them drove up the cost of hearing aids dramatically: $2,300 is the average cost of hearing aids, and for many Americans, insurance pays little or nothing.
Enter the Internet
But the situations is changing rapidly. Cheaper hearing aids are suddenly easy to find, thanks to the Internet and mail-order catalogs. Mail-order sales alone jumped over 90% between 1997 and 2000, the most recent data available.
More and more companies are developing ways to sidestep the physician process and sell directly to the consumer. Waivers are one option; one Web-based outlet, Hearing Help Express, requires customers to sign a waiver before the product can be shipped.
Another option is to market the product differently; Crystal Care International says its Crystal Ear product is an "assisted-listening device," not a hearing aid, and is therefore not obligated to follow FDA standards.
Crystal Care's linguistic gymnastics may not be enough, however. The Lutz, FL, company is being investigated by the Florida Attorney General.
"This company, through various marketing mechanisms such as informercials and national newspaper advertising, sells a $399 hearing aid," Attorney General Charlie Crist said in a statement on his Web site. "The hearing aid is sold in Florida and nationally by unlicensed hearing aid specialists through the U.S. mail, both violations of (Florida law)."
Hearing Help Express sells several models of ready-to-wear hearing aids that come with five different ear tips, so customers can pick the best fit. For those who want a truly custom fit, Hearing Help Express offers materials to make ear impressions, which the customer then mails back to the company.
These personalized products are still considerably cheaper than traditional aids, and range from $500 to $700. Songbird devices are an even less expensive mail-order option, and cost $59.95 apiece.
But look out! Carol of Trinity, NC, had her brother do one such impression. The "simple" procedure was very painful, and for two months after, Carol was unable to hear from that ear.
Finally she discovered that "evidently when the impression was being taken, the eardrum had been punctured," resulting in silicone on either side of the eardrum and surgery to remove it. What was initially thought to be a simple process resulted in a money and time-consuming, not to mention painful ordeal.
Cheaper Sometimes Is Better
While these products lack some of the features of custom hearing aids, many consumers feel the devices offer reasonable results at a reasonable price.
Dr. Mead Killion and his wife Gail, who both hold doctorates in audiology, believe this is just the case. Dr. Killion recently played two recordings before an audience of 50 audiologists. The first was a person speaking in cafeteria noise, amplified by a $149 over-the-counter device. The same speech was amplified again, this time through a popular $2,000 digital hearing aid. Surprisingly, the $149 device was rated the better product. "The point is, there are reasonably good OTC aids out there now," Dr. Killion said.
Devices obtained over the internet or through mail-order may vary greatly in quality, and there are several things to consider before making a purchase.
Batteries pictured on Buyers Haven site
1) Check out the company. Frank of Pequannock, NJ, ordered hearing aid batteries online from Buyers Haven. When they never showed, he attempted to contact the company but found they listed no store location, only an email address. Marsha in Champlain, NE had much the same luck after ordering products through a Sunday paper. She had yet to receive anything from the company four months later. In the event of a problem, be sure the company can be easily contacted and the right persons held accountable.
2) Always visit a physician before buying any kind of listening device. By skipping a formal evaluation, you may fail to diagnose a serious problem, such as an infection, ear tumor, or excessive wax buildup. Nancy McKinney was diagnosed last year with mild, age-related hearing loss. Unhappy with each of the several aids she tried, McKinney returned to the audiologist and discovered she had collapsed ear canals.
Furthermore, a formal evaluation will provide a piece of information often taken for granted: whether the need for an actual hearing aid actually exists.
If the loss of hearing is not severe, an OTC product may be the best and least expensive bet. Dr. Mead Killion and his wife believe this is just the case. "There are a lot of uncomplicated hearing losses in the mild to moderate range that don't require a very sophisticated instrument," says Dr. Killion.
After arthritis and high blood pressure, hearing loss is the third-most-common chronic condition in older people, according to a recent study published in the Journal of the American Medical Association. This market is not going away anytime soon, and if OTC devices continue to push forward, high-end products may see price slashes in order to remain competitive. And that would be music to nearly everyone's ears.