Hearing aids for the masses

New York Times By Shira Ovide

I’ve been speaking with audiologists, consumer advocates and technology companies about what could be a revolution for our ears — hearing aids at a fraction of the cost and hassle of conventional devices.
Here’s how things stand now: Hearing loss is a pervasive and serious health problem, and many people are reluctant or can’t afford to get conventional hearing aids. Nearly 38 million American adults report some degree of hearing loss, but only a minority of people who could benefit from hearing aids have ever used them.

Hearing aids typically cost thousands of dollars, require multiple visits to specialists and often aren’t covered by health insurance. Untreated hearing loss is associated with cognitive decline, dementia and other harms. Overcoming barriers to hearing treatment may significantly improve Americans’ health.
The federal government is poised to help. Congress in 2017 passed legislation that would let anyone buy hearing aids approved by the Food and Drug Administration without a prescription from an audiologist. The F.D.A. has missed a deadline to release draft guidelines for this new category of over-the-counter hearing aids.

Experts told me that when the F.D.A. moves ahead, it’s likely to lead to new products and ideas to change hearing aids as we know them.
Imagine Apple, Bose or other consumer electronics companies making hearing aids more stylish and relatively affordable — with people having confidence that the devices had been vetted by the F.D.A. Bose told me that it’s working on over-the-counter hearing aid technology.

Barbara Kelley, executive director of the Hearing Loss Association of America, an advocacy organization, told me that she can’t wait for more affordable and accessible hearing help. “I’m really excited for the market to open up to see what we got and see how people are reacting,” she said.
It is already possible to buy a hearing helper — they can’t legally be called hearing aids — without a prescription. These devices, called personal sound amplification products or PSAPs, vary wildly in quality from excellent to junk. But when shopping for them, people often can’t tell the difference.

(The Wall Street Journal also recently wrote about hearing helper technologies, including earbuds that can amplify quiet sounds. And Consumer Reports has a useful guide to hearing aids and PSAPs.)
Nicholas Reed, director of audiology at the Johns Hopkins Cochlear Center for Hearing and Public Health, told me that the F.D.A. process should provide a path for the best PSAPs to be approved as official over-the-counter hearing aids. He expects new companies to hit the market, too.

You may doubt that a gadget you buy next to the toilet paper at CVS could be a serious medical device. Dr. Reed’s research, however, has found that some hearing helpers for $350 or less were almost as good as prescription hearing aids for people with mild-to-moderate hearing loss.
Dr. Reed described the best lower-cost devices as the Hyundai of hearing help. (This was a compliment.) They aren’t flashy, but they will get many people safely and effectively where they need to go. He also imagines that the F.D.A. rules will create the conditions for many more people to buy hearing aids — both over the counter and by prescription.

Over-the-counter hearing aids won’t be able to help everyone, experts told me. And the traditional hearing aid industry has said that people are best served by customized devices with expert help.
There is also more technology brewing at the luxury end of the spectrum. A Silicon Valley start-up called Whisper has a novel monthly payment option for its hearing aids and says that its software “learns” over time based on an individual’s hearing deficits.

Health care in the United States can often feel as if it’s stuck, and technology is usually not the solution. But with hearing aids, technology and a change in government policy could bring helpful health innovation.