Last week, hearing aids were made available over the counter (OTC) for people with mild-to-moderate hearing loss. Though the new rule increases the ease of convenience and reduces the price of hearing aids, there are still some challenges with this new category of device. The price range of OTC hearing aid is between $200 and $1,000, although devices with self-fitting features that personalize the device to an individual’s hearing may be around $800 to $1,000 per pair, making them less accessible as they may someday become.
That’s according to Vinaya Manchaiah, AuD, PhD, visiting professor of otolaryngology at the University of Colorado School of Medicine and director of audiology at UCHealth.
“There are two types of over-the-counter hearing aids — one that has a self-fitting feature to personalize them to your hearing, and a pre-set hearing aid. The OTC hearing aids with the self-fitting feature are priced close to low-cost prescription hearing aids, making them less accessible to people with lower incomes,” Manchaiah says. “But I think that this is just the beginning. Hopefully, the competition will force the market to produce good and more affordable devices in the future.”
Hearables, personal sound systems, and OTC
Prior to October 17, when over-the-counter hearing aids first became available in the U.S., consumers had two choices when they needed help hearing: personal sound amplification systems, which typically serve as hearing-enhancement products, and “hearables” — wireless earbuds designed for multiple purposes such as music listening, fitness tracking, etc. Both of these categories have features and functionalities similar to those of conventional prescription hearing aids, although they were not meant to be marketed to people with hearing loss.
“Over-the-counter hearing aids, however, are FDA-approved devices that work like their prescription counterparts and are suitable for people with perceived mild-to-moderate hearing loss,” Manchaiah says.
Manchaiah does caution that many OTC hearing aids may lack some of the functionality of prescription hearing aids, including smartphone and Bluetooth integration and wireless charging. This may be an important consideration when purchasing a high-cost OTC hearing aids, he says, as low-cost prescription hearing aids often have better features and functionalities at a similar price point.
Pluses and minuses
A primary advantage of OTC hearing aids is that they reduce barriers around access, Manchaiah says. People in rural or remote areas can now take a hearing test online and order hearing aids from local pharmacies or retailers.
“The other advantage of over-the-counter hearing aids is that this category will force the hearing aid market to produce better-quality products with a cheaper price point,” he says. “Even people with milder hearing problems who never thought about prescription hearing aids may say, ‘Oh, I do have hearing problems in some situations; I may benefit from these OTC devices.’ This may help expand the use of these interventions in people with mild-to-moderate hearing loss who don’t always consider hearing interventions.”
Some of the new OTC hearing aids also look more like earbuds, Manchaiah says, reducing some of the stigma around wearing them.
Manchaiah sees some challenges and limitations around OTC hearing aids as well, the first being that there is bound to be confusion over hearing aids vs. hearables vs. personal sound amplification systems. It is important, he says, to look for the words “over the counter hearing aids” on the packaging — and to conduct research to make sure you are purchasing a high-quality hearing aid.
The devices can also be tricky to adjust and difficult to set up, especially for those who aren’t used to working with technology. He foresees a new role for audiologists — helping people with OTC hearing aids set up and manage their new devices.
Help is available
“Many people probably will be able to manage these devices fine — they can probably choose a good device, personalize it as they want, and then handle it fairly easily,” he says. “But I think some people are going to struggle in one of these three aspects. They may not purchase the right device, they may pick a poor-quality device, they may not have the ability to personalize it, or they may have handling issues, like how to change the batteries. I think some people may need additional help.”
Even though people aren’t required to get a hearing test prior to purchasing OTC hearing aids, Manchaiah strongly suggests it so people know exactly the problems they are looking to solve. He is currently working on making an online hearing test, accessible by smartphone, available to UCHealth patients as well as to the public. He also recommends purchasing a device from a company that offers good customer support and has a return policy.
“Of course, they can visit an audiologist if they need additional support,” he says. “People can spend a lot of time online, although they may not necessarily end up with all the right information. For individuals who are struggling to troubleshoot their problems online, it may be easier to just go to an audiologist and get some help.”
