Opinion: inexpensive hearing aids may not benefit consumers in the long run

On World Hearing Day – 3 March 2017 – while global initiatives were being rolled out to advocate for people with hearing loss and to ensure that effective systems are in place to deliver this, the Australian Competition and Consumer Commission (ACCC) put the Australian hearing aid industry on notice for inappropriate sales behaviour.

Following on from this, The Sydney Morning Herald referred to the hearing aid industry as “an opaque industry with suspicious practices”, whereas Better Hearing Australia president Michele Barry said that there were many reputable clinicians in the industry, but part of the problem was the sector’s self-regulation.

At the heart of these arguments is a concern about the difference in the cost of purchasing hearing aids online compared to through a hearing service. Currently, purchasing these hearing devices through the internet is generally less expensive than purchasing them through a hearing service provider, with device costs also varying greatly across service providers in the hearing industry. In light of this, the recommendations made by the ACCC were centred around informed choices, highlighting that consumers need to be aware of what they are actually paying for when purchasing hearing devices.

Firstly, it is important for consumers to understand that the lower prices of internet-bought hearing aids are due to the fact that buyers are only paying for the cost of the technology. On the other hand, in Australia and in the US, the costs of these devices through hearing provider services are usually bundled to include the cost of the technology, the professional services needed to individualise the user experience for each device, as well as the rehabilitation needed to optimise outcomes.

Hearing aid technology is expensive because it relies on rapid digital processing to make precise decisions about what is speech versus what is noise, and amplify or quieten sounds accordingly.

Programming a hearing aid to suit an individual and the type of sounds they experience daily typically takes more than a single appointment. Therefore, many hearing clinics offer 1-2 additional appointments, usually included within the original device cost, to ensure that the hearing aid is effective for the types of environments that the user experiences often. As hearing aids are often tricky to insert the first few times and batteries are hard to change, partly due to their small size, these appointments are also useful to ensure that the client or their carer is competent in the hearing aid’s operation and placement.

Secondly, hearing loss is a chronic problem and consumers need to understand that a hearing device solves only part of it. Hearing loss due to advancing age typically occurs slowly and, as such, it takes about 7-10 years from the time that a hearing problem is first noticed to the time that a person makes their first visit to a hearing service provider.

Importantly, hearing loss is known to disrupt many aspects of a person’s life. For example, after 10 years of suffering from a hearing loss, a person will usually have experienced multiple impacts from their inability to hear sufficiently, including effects on their family and social relationships, a reduction in the number or quality of social outings, and a change in one’s social identity. Therefore, in many cases, it is not only the hearing loss that a hearing service provider needs to address, but also the potential psychosocial impacts of a decline in hearing as well.

Thirdly, consumers need to be aware that one of the most challenging types of hearing loss for a hearing service provider to manage is a mild-to-moderate hearing loss. For these milder types of hearing loss, the value of hearing aid technology is variable.

While various people get a lot of benefit from the devices, others do not. For some, the problem lies in the fact that the technology is not sufficient in addressing their main concern: to hear speech clearly in background noise. In such cases, a hearing aid trial is therefore useful, and so consumers with a mild-to-moderate hearing loss may benefit greatly from visiting a hearing service provider.

When visiting a hearing clinic, it can also be useful to take the opportunity and time to discuss one’s expectations, as providers can also offer other possible solutions if a hearing aid is not right for an individual, or not the right solution for now.

Within the same month of the ACCC report being released in Australia, the US Government has introduced the Over-the-Counter Hearing Aid Act of 2017, where people diagnosed with milder forms of hearing loss can purchase their hearing aids without professional consultation. While this may seem like a cost-effective solution in the short term, the numbers of hearing aids that might not be worn because they were not the most appropriate type or the most appropriate solution, could increase. As such, the solitary purchase of hearing device technology without additional services could ultimately increase costs to consumers.

In short, hearing healthcare should not be in the consumer market. It should continue to reside in the healthcare arena with more effective regulation over the industry. Maintaining beneficial communication across the lifespan should be a health priority, as good hearing is important for healthy ageing and increases independence for our older population.

Catherine McMahon is a researcher, clinical audiologist and head of audiology at Macquarie University’s Australian Hearing Hub.

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