Over-the-Counter hearing aids: A two-year review.

While you can purchase over-the-counter hearing aids, there are still plenty of questions that need to be answered - Photo by UnSplash +

The consensus? We're not there yet.

Is the blush off the rose for over-the-counter (OTC) hearing aids? We’re now a year and a half in since the introduction and there’s been enough time for consumers to try them out that a balance sheet of yays and nays is starting to emerge. 

Hailed as the second coming, OTCs were supposed to get more people experiencing mild-to-moderate hearing loss into the hearing products market. Collectively, the tact taken by most OTC manufacturers was to dangle lower prices, miracle-level marketing language, self-fitting capabilities, and removal of the stigma of going to an actual audiologist to get tested.

Second coming or not, the results are mixed. Data from an ASHA OTC Hearing Aid Survey suggests the expected boom in adoption has yet to get the lift-off OTC makers had hoped for. According to that data, only 2% of those with hearing difficulties bought a pair and just 4% said they’ll buy some in the next year.

Product returns also seem to be a problem. Reports say it’s as high as 50% at some retailers. If true, that’s a lot of OTC-triers who became OTC-rejectors.

The hearing teeter-totter consumers are forced to ride

Consumers inherently want the highest quality product for the cheapest price. That’s fine if you’re buying a 12-pack of Coke, but people with hearing problems aren’t a one-size-fits-all group.

In discussions with hearing professionals to get a good idea of where 2024 and OTC candidates sync up, ConsumerAffairs found several emerging factors worth considering.

First, who is a candidate for the devices?

There are “situational” wearers – people who need to hear the dialogue on their TV clearly or discern conversations better. On the other end are those whose hearing was damaged by something like factory noise. The distance between those two poles is where many people exist and that’s where the confusion lies.

Then, there’s the task to figure out how good or bad your hearing is.  

OTC’s are for “perceived” mild-to-moderate hearing loss. Ask the U.S. Food and Drug Administration (FDA). But, just like you might “perceive” yourself to be “mildly” as good of a singer as Taylor Swift or “moderately” as good an athlete as LeBron James, your perception is probably not the reality. And finding that reality is confusing. 

To get that answer, consumers have to decide if they’re smart enough to determine how bad their hearing is by themselves – either via guesswork, an online “test,” or getting a screening from an audiologist. 

Zeroing in on the target that works for most, the Hearing Industries Association’s Dr. Tom Powers told ConsumerAffairs if there’s one thing consumers need to know about OTCs, it’s that they need to make an informed decision.

“Informed decision,” meaning a real hearing test from a real audiologist and not an online widget. Unfortunately, for consumers, Powers says that most of the tests you’ll find online are a “gross approximations” at best and can produce false results versus an audiologist-controlled environment where the distractions are off and the findings are industry standards, not what the company behind the widget pushed out as the result. 

To their credit, some companies offering online hearing tests – like United Healthcare and Starkey – are upfront about what the consumer’s takeaway should be. “The online hearing test is not designed to replace a professional hearing test. If the results indicate hearing loss, you'll be presented with the information that will help you choose the care option that's best for you,” United says alongside its online widget.

Are OTC manufacturers making any changes that are pro-consumer?

With the results being somewhat mixed, OTC manufacturers might be revisiting the drawing board to reevaluate how they can get better consumer buy-in. Dr. Catherine Palmer of Audiology.org told ConsumerAffairs that some OTC makers may just fold their tent and go home, but others are reviewing the feedback they’ve received from users and making changes.

ConsumerAffairs reached out to several OTC manufacturers to find out what they’ve learned about their OTC customer base and what they have planned in the way of advancing service or technology.

Jabra Hearing and Lucid Hearing were the only companies that responded and indicated that they were proactively addressing the kind of potential customer service concerns that were plaguing OTC adoption. 

Lucid Hearing found that while 57% of consumers were familiar with the new category, many were hesitant to purchase OTCs due to concerns about quality and fit—as well as a lack of feedback from other users. To address those concerns, Lucid’s response is to offer perks like free hearing evaluations, personalized service (cleaning, fitting), and a 90-day return policy for customers who purchased OTC hearing devices at over 500 Sam's Club locations.

Also breaking away from other manufacturers who are doing just the bare basics, Steve Jacobs, president of Jabra Hearing, told ConsumerAffairs that “One of our primary challenges has been educating consumers that complete solutions like these exist over the counter and emphasizing the importance of considering audiology care and key features like a 100-day trial period when evaluating OTC purchases. We’re making sure that we feature these prominently in how we position our devices.

“We’re a year and a half into the FDA’s new OTC hearing aids category, and the market is still trying to both understand and adapt to consumer preferences when it comes to these devices. The challenge we’ve found with OTC is that while those three letters can imply lower cost and more accessibility for consumers, they can also imply that devices are less powerful, primarily self-service and absent of Audiologist care. We’ve found that people are not expecting that there's Audiologist care with OTC devices, and they're not expecting it to be as high quality of a device. Yes, there are lower-end, not as sophisticated devices available on the OTC market, but there are also comprehensive solutions like ours,” he said.

Cost and service hassle?

The self-testing aspect is an important spoke in the OTC wheel, but once a consumer heads down that road, they better be prepared for a long, potentially bumpy, ride.

“The first thing a consumer who has perceived mild-to-moderate hearing loss should consider is ‘do I want to pursue self-care?’,” Palmer reminds consumers. “Self-care implies that the individual has the time, energy, and interest to sort through the various choices, make a final selection, and then self-fit the device and teach themselves care, maintenance, and appropriate use.”

Or – as Dr. Ruth Reisman, founder and co-owner at Urban Hearing puts it – “It's like trying to manage your own bookkeeping or taxes,” she said. “I'd rather spend the money for someone to do it right than try to figure it out on my own and have to pay more later on for making a mistake.”

Consumers need to consider post-purchase costs for service and replacements, too, because if you buy OTCs and something goes wrong, you’ll probably be out some money. For example, the warranty for Sony’s OTC hearing aids is one year and covers repair but not a replacement for loss or damage. By the time a loss like that is recovered, you might as well have paid for prescription hearing aids where you’ll get free fitting, free service, free cleaning, loss replacement, and a three-year warranty.

We’re simply not there, yet

As ConsumerAffairs looked at all sides of the OTC debate, the takeaway is that the OTC world is not “there”... yet. 

Julie, Volunteer Mentor on MayoClinic.com's Hearing Loss discussion group, and a longtime hearing aid wearer, put it this way: "I know enough about them to realize that many of the OTC products available now are similar to the hearing instruments I was fitted with back in the 1970s. In the early stages of progressive hearing loss those aids were helpful as they amplified speech I struggled to hear. They did not clarify it, though. Today's more sophisticated products can be adjusted to help with clarification but in places where background noise is prevalent, they still function as 'aids' rather than solutions.”

However, she does think things are going in the right direction. 

“The key to hearing in noisy environments remains by using add-on technology that brings the desired sound directly to a person's hearing instruments,” she said. “Kind of like 'binoculars for the ears'. That is why BlueTooth and telecoils can make such a positive difference in settings where they work. It keeps getting better, but we are not there yet!"

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