Hearing loss is a problem that affects millions of people worldwide, and in America approximately 15% of adults report some trouble hearing. Despite this huge number, only a smaller percentage of people with hearing loss wear hearing aids. This small percentage of people who opt for hearing aids is somewhat surprising, given the growing evidence for associations of cognitive decline and hearing loss. This blog post will review potential upcoming changes that may alter public perception of hearing aids and improve people’s ability to purchase these devices.
What are the current barriers for obtaining hearing aids?
There are a variety of personal, social, and economical factors that contribute to this discrepancy, and cost is one of the main issues many people face in obtaining hearing aids. A single pair of hearing aids can cost more than $4,500, which makes hearing aids prohibitively expensive for many people. In addition, most health insurance does not cover hearing aid costs.
It is easy to understand why people are frustrated with the lack of affordable hearing aids, and the limited insurance coverage for even part of the cost. Currently, there are no "hearing aids" approved for over-the-counter (OTC) purchase, and any hearing assistive devices sold OTC would not technically be approved for hearing loss. While they may be helpful for some people, the lack of regulation on the devices creates uncertainty about the products currently available OTC. Currently, hearing aids can only be obtained with approval by an audiologist or physician, so there is time and medical expense involved just to obtain hearing aids, in addition to the cost of the devices.
What is being done to improve accessibility?
Fortunately, the Food and Drug Administration (FDA) has been working to approve OTC hearing aids. This process started in 2017 when Senator Elizabeth Warren proposed the Over-the-Counter Hearing Aid Act, which was passed by Congress. The next step in the process was for the FDA to propose regulations on OTC hearing aids by 2020, but this process has been delayed due to the worldwide COVID-19 pandemic. Nonetheless, this proposal and regulatory step has potential to have a huge impact on access to hearing aids for millions of people in need.
It is worth noting that the Act is for the approval of hearing aids for people with mild to moderate hearing loss. Hearing loss in this range can often go unnoticed by the individual, because the ability to hear in quiet settings is often not disrupted, but a simple clue would be if you are having difficulty hearing in an environment with background noise, or if you note that you are having to turn up the volume on your TV.
How would OTC access help people who need hearing aids?
There are a number of ways that approval for OTC hearing aids would be beneficial to the public. Primarily, OTC access would reduce the time and effort that is currently necessary for getting hearing aids. Currently, people with hearing loss need a hearing test, approval by a licensed practitioner, and an evaluation to determine which hearing aid would best suit their needs before purchasing hearing aids. A single trip to the store for an OTC purchase would offer immediate opportunity for hearing aid use in a mostly elderly population that may depend on resources just to get to their medical appointments. Next, by opening the market to expand access to hearing aids, there would be various options and incentives for companies to meet a market need and create products, which should help regulate and reduce costs. Right now there is little competition in the market, which may be part of the reason for the high cost of these devices.
A few things to consider as we wait for FDA approval
Making hearing aids available for OTC purchase is an overwhelmingly positive next step for hearing loss, which is a major public health issue. However, there are things that people need to be aware of as we prepare for the FDA approval. Most importantly, not all hearing loss requires hearing aids. There are a number of different types of hearing loss with a long list of potential causes. It is likely still a good idea to check in with an audiologist or otolaryngologist (an ear, nose, and throat doctor) if there are symptoms other than just hearing loss, such as pain or drainage of the ear, hearing loss in only one ear, or vertigo associated with your hearing loss. Similarly, if your hearing loss is so severe that hearing aids (OTC or otherwise) do not benefit you, it is possible that you need more than just hearing aids.
Next, it is important to realize that there will be some variability in the products available, and that part of the reason hearing aids are currently so expensive is that they have a lot of electronic features that offer benefits for specific types of hearing loss. So if you are unsure about the degree of your hearing loss, or the type of hearing loss you have, a formal hearing test may be necessary.
Finally, there are lots of nuances to fitting and wearing a hearing aid. With OTC purchases, you may not be able to get customizable parts, and the opportunity for a simple repair of a hearing aid may be challenging since it was purchased OTC.
The opportunity to improve the quality of life for millions of people with hearing loss is promising, and improving access to hearing aid technology is an important initiative that will hopefully be here soon.
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