Are OTC hearing aids ready for prime time?

Five years ago I questioned whether the burgeoning class of “hearables” was ready for prime time, and my answer was “not yet.” Sure, earbuds for streaming music and talking on the phone were ready for takeoff. But hearables designed to actually help you hear a lot better—especially in your favorite noisy restaurant—never seemed to catch on in a very big way.

Now we are entering the over-the-counter hearing aid era, which is supposed to blow the market wide open with low-cost hearing aids that don’t require a visit to the audiologist. Unfortunately, I’m suffering from a strong sense of deja vu. 

Why? Because many of the same obstacles that limited customer adoption of hearables will slow market acceptance of OTC hearing aids as well. And I’m not just talking about price. Here are three product and technology issues that are forcing manufacturers to make tradeoffs:

• Miniaturization: Jamming good custom amplification, directional microphones, plenty of sound processing power, Bluetooth capability, and long-lasting battery power into a device smaller than the tip of your pinkie finger is very, very, difficult. The smaller the form factor, the more technically challenging and expensive, forcing designers to trade off features and functions that many customers want.
• Sound processing: Good algorithms are available that suppress unwanted sounds and boost speech and other sounds you want to hear. But programming them to each user’s distinct hearing profile is still a challenge that often requires professional help. Only a few OTC hearing aid makers have launched do-it-yourself “self-fitting” apps, and the jury is still out on whether they will be effective or user-friendly enough to catch on with consumers.
• Multifunction applications: The success of Apple’s Airpods and other earbuds designed to stream music and phone calls, monitor your heartbeat, and count your steps has created consumer expectations that whatever goes in their ears should do more than simply help them hear better. OTC hearing aid makers that offer excellent sound processing but none of the other “extras” run the risk of positioning themselves merely as slightly less expensive me-to alternatives to established hearing-aid brands.

Don’t get me wrong. I agree with news outlets such as CNN, which hailed the introduction of lower-cost OTC hearing aids as a potential “game-changer for millions.” With new rules deregulating the U.S. market going into effect today, plenty of new OTC hearing aids are on the way. We will see a lot of innovation combined with lower prices. But I’m betting the game won’t change overnight. It will take a few years for this nascent market to start reaching its full potential.

A case in point

On first look, Sony’s collaboration with WS Audiology claiming an early stake in the OTC-market land rush appears to be a potential winner. Here’s how Sony describes it::

"Developed in partnership with WS Audiology, this hearing device combines leading audiologist expertise with Sony’s trusted technology to deliver exceptional sound quality in a sleek, discreet design that’s virtually invisible." (Source: Sony product overview)

But Sony is actually introducing two products, and the feature mix of each is a good example of the tradeoffs OTC hearing-aid manufacturers must make to deliver quality hearing improvement at lower costs than traditional hearing aids:

• The CRE-E10 has an earbud design that—at least in the eye of this beholder—isn’t quite “virtually invisible.” But it does offer Bluetooth streaming of music and phone calls. Its integrated rechargeable batteries are expected to last all day, but the hearing aids must sit in the charger unused for extended periods.
• The CRE-C10 is a smaller device that sits within the ear canal and comes closer to meeting the invisibility test. For power it relies on disposable hearing aid batteries that must be replaced periodically but promise approximately 70 hours of use. However, there’s no Bluetooth streaming.

The good news is that Sony’s new hearing aids are based on high-end hearing technology from WS Audiology, one of the world’s top five hearing aid manufacturers. The CRE-C10 and CRE-E10 are rumored to utilize technology found in WS Audiology’s proven Signia Active Pro and Signia Silk hearing-aid models. So the hardware is solid. 

But the effectiveness of the self-fitting Sony Hearing Control app that users can download to program the hearing aids is an open question. (The best review I’ve seen of the new Sony hearing aids comes from Matthew Allsop on Hearing Tracker’s YouTube channel—if you’re thinking about buying an OTC hearing aid, it’s a must.)

The elephant in the room

Given their tradeoffs, both Sony products may fall short of the ideal OTC hearing aid. But they are still a promising early entry. Except, perhaps, for one small detail—price. A pair of the smaller CRE-C10 model that use disposable batteries and don’t feature Bluetooth is listed on the Sony website at $999.99. A pair of the larger, earbud-style rechargeable CRCE-E10s with Bluetooth streaming is listed at $1,299.99.

Both prices are somewhat less than what many audiologists in private practices charge for hearing aids with comparable power and features. But prices charged by audiologists include a personal hearing test administered by a medical professional, with multiple visits for updates and adjustments to fit amplification levels to the individual’s unique hearing profile. It’s an open question whether the self-fitting app that comes with the Sony OTC hearing aids will provide equally good results.

Price will remain the elephant in the room until we see one or more OTC hearing aids hit the sweet spot with performance and feature sets at attractive price points that generate massive sales. That scenario may eventually be possible, especially if the OTC self-fitting apps that are less costly and easier to buy actually deliver hearing improvement equal to or better than what customers can get with multiple visits to the audiologist.

Waiting for the first hit product

In the meantime, think about what consumers spend on a high-end smartphone these days—somewhere in the range of $500 to $1,200. Which raises a question: will your equally expensive OTC hearing aids provide you with the same satisfaction and quality-of-life improvement that your apps-laden iPhone or Android phone provides?

In fact, the mobile phone market is a good example of how long it can actually take a new, deregulated product to hit critical mass. In the U.S., the phone system started deregulating in 1984, and we saw the the first brick-sized mobile phones like the ones used by the poor guy in the picture at the top of this post. In the 1990s we saw a lot of cell phones from Nokia and Motorola, but service was spotty and apps initially were limited to expensive messaging. It wasn’t until 2007, when Apple introduced its iPhone, that we saw the market explode. Apple finally hit the tipping point with a product that combined multiple functions that users craved while being just affordable enough to reach a global mass market.

But that process took more than 20 years. Will a deregulated U.S. hearing aid industry with a new class of OTC hearing aids hit a tipping point faster? Let’s hope so. But before it does, there’s still plenty of work to be done on both product and price.