Back in October of last year, I decided to face up to the fact that, like many others my age, I was experiencing age-related hearing loss, also known as presbycusis. In part, my hearing loss may also have originated from controllable factors such as working with loud machinery, including chainsaws, and in a computer server room with lots of cooling fans.
In the intervening months I’ve learned a lot about the hearing aid business, and I have come to know that there is no one straightforward solution when it comes to dealing with hearing loss.
Standout findings for me:
- Most hearing aids cost either $2,000 or $6,000+
- Android phones are problematic with hearing aid software
- Just a handful of companies control much of the hearing aid business
- Recent model hearing aids use rechargeable batteries
- Over the counter (OTC) hearing aids from the U.S. are spilling over into Canada
- Artificial intelligence software should bring improvements in the near future
- In the long term we may see a medical solution to hearing loss
Perhaps one aspect of my experience that stands out most starkly is that there are two distinct sectors in the hearing aid business: one where the typical solution costs on the order of $6,000 or more, and another sector where the typical cost is around $2,000.
Early on in my investigations I came across retired doctor Ken B. His observations have resonated with me throughout this process. I approached him because I noticed he was wearing hearing aids. As it was, they were very much like the units I was testing at the time produced by Phonak.
He told me that although he wasn’t quite at the point where he needed hearing aids, he had decided to get a pair so he could acclimatize to them gradually and be ready when they became a necessity. Rationalizing that hearing aid technology is ripe for rapid change, he decided that it made no sense to spend $6,000 on aids that were likely to be replaced with dramatically improved capabilities in short order.
In short, he purchased a pair for $2,000 at a big box store and has been very happy with them. Unfortunately for me, by the time I arrived at the store, the Phonak brand was no longer being carried and could only be acquired at much higher prices through industry-owned storefronts.
Another example of rapid change in hearing aid technology is the emergence of tiny rechargeable batteries. Up until about three years ago, hearing aids came with finicky replaceable batteries. Today, such aids are almost gone, replaced by chargeable units.
Also making inroads today is artificial intelligence. I am currently testing aids produced by Rexton. The app for these aids incorporates a form of artificial intelligence branded as Rexton Assist. Basically it asks you if you are experiencing certain problems such as unnatural voices, loud machine sounds, or too much of your own voice, and it then attempts a fix on the fly. If you are happier with the fix you have the option to keep it. Otherwise it reverts to the previous settings.
I’ve found this process very helpful and the aids nearly as good as units costing three times as much. In fact I was surprised how good this software was at pulling the most I could out of the aids.
When I returned my previous Jabra aids, the Costco audiologist suggested I try Rexton as it has slightly better upper frequency range and ear sleeves that may help better with directionality. Rexton is made by Sivantos, now WS Audiology, a company that makes around 25 per cent of the world’s hearing aids.
As an Android phone user, I do have connectivity problems for streaming. I’ve now come to accept this, knowing that the big manufacturers are really focusing on the Apple iPhone ecosystem. They know that iPhones are all pretty much identical, whereas the Android marketplace is fragmented. It simply isn’t worth the effort for these big companies to ensure compatibility with a wider range of Android phones. Furthermore, the senior demographic likely to be acquiring hearing aids is far more aligned with the Apple world than with Android handsets, at least in North America.
If you’ve made an internet search for information on hearing aids, and if you are also a Facebook user, you have certainly received ads from many suppliers. For me, a standout among such ads is a series from so-called over-the-counter sellers. In the United States market, such OTC sales have emerged the last couple of years after the FDA approved this form of direct marketing without the need for consultation with a hearing professional.
These companies are also selling into the Canadian marketplace, typically at prices of around $1,000 for a pair. Whether we will see such aids sold directly here in B.C. remains to be seen. Presumably, audiologists and registered hearing aid practitioners would not be happy with such a development.
Bloomberg’s Mark Gurman writes in his newsletter that Apple intends to take advantage of the FDA’s OTC sales approval by rolling out a hearing aid mode for its AirPods Pro line, bringing further disruption to the market.
Just as this column was being finalized a scientific paper appeared on a new approach to the treatment of hearing loss. Hearing aids do not treat the underlying causes, such as damage to fine hairs, or cilia, in the inner ear. Researchers at University College London and elsewhere in the UK have discovered that damage to these cilia can be repaired through a gamma-secretase inhibitor injected directly into the inner ear.
For now it is early days for the possibility of a medical solution to hearing loss. Initial trials showed that about 50 per cent of participants were able to hear sounds 10 decibels below their previous lowest level before the inhibitor injection. That’s promising, but not enough for the researchers, who wanted an average improvement of 10 decibels at three frequencies across the audio spectrum.
Going forward, artificial intelligence will undoubtedly drive improvements for physical hearing aids. It may also speed up the identification of molecules that can help with restoration of actual inner ear functionality.
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