Hearing Aid Facts and Figures

Katherine Bouton #HLAA., FDA and hearing aids, Hearing Aids, OTC Hearing Aids

Almost a year after the passage of the Over-the-Counter Hearing Aid Act of 2017,  I was curious to know if the bill and the attendant publicity had affected the hearing aid marketplace. So I asked an expert: Abram Bailey of Hearing Tracker.save-money-image

OTC hearing aids won’t be on the market for months, if not years. But the one-year anniversary seemed like a good time to try to establish some kind of benchmark in terms of sales, prices, location where purchased, brands, cost and other issues that may begin to shift after OTC hearing aids become available.

The bipartisan OTC bill, sponsored in the Senate by Republican Chuck Grassley and Democrat Elizabeth Warren, was signed into law by President Trump in August 2017. The FDA, which regulates hearing aids, has three years from the time the bill was signed for comments and questions. The final regulations will reflect the views not only of consumer advocates but also of audiologists and other medical professionals as well as hearing aid companies and dispensers. Until that comment period is over, there will be no OTC hearing aids.

Abram Bailey constructed a survey that was filled out by over 2000 consumers. (Here is a link to the survey) The respondents were a self-selected group, already aware of their hearing loss and many already wearing hearing aids. The survey was sent to Hearing Tracker followers, HLAA members, and people who follow my blog.

Part 1 of the survey was published last week. Parts 2 and 3, focusing on hearing-aid preference and recommendations, insurance coverage, and purchase of accessories (assistive listening devices, for instance), will be published in the coming weeks.

The survey first established the demographics of the respondents: 54.7 were female and 44.2 male. More than three-quarters were over the age of 55, with pretax income that reflects that of the population at large. More than half were retired. Their self-reported levels of hearing loss ranged from mild to profound, with 18.2 percent reporting that their hearing loss was profound, and 31.4 percent reporting severe hearing loss. As would be expected from the respondents surveyed, many were experienced hearing aid users, over half with 10-plus years of use. This is a very different sample from those who are just now becoming aware of their loss and buying hearing aids, but the trends are interesting.

Almost all (84 percent) bought a pair of hearing aids, as opposed to a single aid. More than half bought what they understood to be top-end hearing aids and more than a third bought mid-range hearing aids. The average price paid was $2560 for a single aid, or $2,336 per aid when purchased as a pair. This is more or less in line with the reports from the President’s Commission on Hearing and Technology (October 2015), which recommended a “basic” hearing aid, and the National Academies of Sciences, Engineering and Medicine (June 2016), which found an average cost of approximately $4700 for a pair of hearing aids.

The top brand purchased by survey respondents was Phonak, with Oticon and ReSound second and third. Eleven other brands were purchased by at least 10 respondents. Not surprisingly, the share of the US market reflected sales figures, with Sonova (Phonak) accounting for 30 percent. William Demant (Oticon) and GN Resound third. All three also own other brands. (The market share statistics date from 2015, and may have changed.)

Did cost affect market share? Starkey (# 4 in market share at 16 percent) had the highest average price paid ($2,674), with Widex (with 3 percent of market share) being the second most expensive ($2,672). The least expensive were Kirkland Signature (Costco’s house brand) at $963.

I was interested to see that the vast majority were fitted by and bought through audiologists (75.18 percent) or hearing-instrument specialists (20.46 percent) Audiology training is far more rigorous than that of hearing instrument specialists. Hearing aids sold by audiologists (1056 responses) cost on average $2,499 per device, those sold by hearing instrument specialists (337 responses) $1944 averaged per device.

The data also revealed, however, that hearing instrument specialists and audiologists seemed to charge the same amount when in similar settings (a local office, for instance). The disparity may reflect the fact that at Costco hearing professionals are mostly hearing-instrument specialists (40 percent) with only 4 percent audiologists. Those who bought at Costco, the survey found, were more than twice as likely to have been fitted by a hearing aid specialist as by an audiologist. Costco’s current estimated market share is 11 percent of all US hearing aid sales.

Costco sells, in addition to its own brand, Phonak and Resound, at vastly reduced prices. How is this? Abram Bailey speculated that it may be due in part to the fact that the aids sold are not the brand’s latest model (usually one generation behind flagship stores) Costco also can purchase in volume, and has very little overhead for its hearing aid sales.

Most surprising to me was the response to a question about the length of time it took for respondents to buy hearing aids once they had learned about their hearing loss. It is commonly said that most people wait 7 to 10 years before buying hearing aids. Over half the survey  respondents reported buying their first hearing aids within two years of learning they had a loss. As Bailey noted, this discrepancy may be the result of sampling bias (the respondents were all already hearing-aid users) or erroneous self-reporting (a respondent might like to think she had bought hearing aids within two years when in fact it had taken her 4-5 to make that decision.)

As the survey says, Stay tuned for more.

 

 

Do Your Hearing Aids Sweat?

Katherine Bouton #hearingaids, #HLAA.

outdoor-thermometerhygrometer-picture-id153970895

It’s hot. And humid.

Perfect weather for ruining your hearing aids.

Moisture. Whether it’s humidity or sweat, getting caught in a downpour, or diving into the pool, moisture is terrible for your hearing aids. It’s damaging to the delicate inner workings (the microphone, flexible circuit board, disposable battery, receiver and antenna). And it can clog the tubing that connects your behind-the-ear processor to the in-the-ear component.

Wax: Hot weather seems to increase wax buildup, which can block your hearing and makes your hearing aid dirty. If you have a custom mold, waxy buildup may make the in-the-ear mold uncomfortable. If your hearing aid has wax guards, make sure you replace them regularly. If it doesn’t, a small brush and pick to clean wax out of the tubing and ear mold is helpful. Don’t forget to clean the battery compartment.

Full immersion? Accidentally dunked your hearing aids?  Don’t panic. Take the hearing aid out and remove the battery (discard it). Shake the hearing aid to remove any excess moisture. If the water is salt water or dirty, rinse the component with fresh water. Dry it off and then leave it on dry newspaper overnight. You can also use a hair dryer but only on a cool setting. Audicus suggests putting the aid into a jar of uncooked rice. Never expose the hearing aid to heat, and if you’re thinking maybe the microwave would be faster, don’t do it!

Many people routinely put their hearing aids in a hearing aid dehumidifier overnight. This would also be a good place for the wet hearing aids as well. Harris Communications offers a variety of these, as does Amazon.com and other retailers..

Do hearing aids sweat? No, it just feels like it.

For more about living with hearing loss, see my books at Amazon.com.

 

Where Hearing Loss is the Norm

Katherine Bouton #hearingaids, #HLAA., Healthy Hearing, hearing aid costs

There’s one event a year where my hearing loss is not afb_nyc_chapter FB profile factor in my ability to communicate.

That’s the Hearing Loss Association of America’s annual Convention.

This year’s convention was held in Minneapolis June 21st to June 24th. I don’t know how many attended but virtually everyone was deaf or hard of hearing – or accompanying someone deaf or hard of hearing. A few audiologists also attended – it’s great to see their interest in what people with hearing loss want and need.

Convention is a mix of lectures, workshops, parties, seeing old friends and making new ones.

GIRLS OF MINNEAPOLIS
At Convention, where hearing loss is the norm.

The larger events – the keynote address, the research forum, the awards brunch – offer three different forms of hearing accommodations: a hearing loop, CART captions, and ASL interpreters. The smaller workshop gatherings provide CART, some offer looping as well, and an ASL interpreter was available on request.  My hearing loss is severe enough that I need CART as well as the loop. The Deaf may use CART to elaborate on what they hear through the ASL interpretation. It’s actually thrilling to be in a place that offers so many different ways to hear

This year’s keynote speaker was Gary Shapiro, president and CEO of the Consumer Technology Association. Consumer electronics are playing an ever larger role in correcting hearing loss. Shapiro’s talk was a guide to this exciting new field of hearing instruments.

The three-hour Friday morning research symposium consisted of a panel of four experts discussing listening in noise. They explained why it is so difficult for hearing aids and cochlear implants to correct for background noise, and technological innovations that  may solve this problem.

As always, there was a large exhibit hall where you could try out new devices, find out how to get a hearing dog, how to add an app to your smartphone to make it easier to understand on a cell phone. My cochlear implant manufacturer, Advanced Bionics, even made a minor adjustment to my cochlear implant at the convention, adding a small magnet to my headpiece, which had been slipping.

The themed Get Acquainted Party is always popular with newcomers and old hands alike. This year’s theme was the 70’s, complete with Go-Go dancers and hilarious costumes. On Saturday evening, Mandy Harvey, a deaf singer-songwriter who was also an America’s Got Talent winner, gave a concert for a few hundred people, some of whom could not resist getting up to dance.

Saturday night, a group went to the famed Guthrie Center for a performance of “West Side Story.”

Workshops on four educational tracks occupied the daytime hours. These tracks included Advocacy, Hearing Assistive Technology, Living with Hearing Loss, and Hearing Loss in Health Care settings. The last category is a new one for HLAA, and it addressed how people with hearing loss can make sure an encounter with the health-care system includes clear communication from health-care professional to patient, and vice versa.

In between formal events, friends met for meals, or a walk in beautiful Minneapolis, or took a trip to the Walker Art Museum and the adjacent outdoor sculpture park. Big name tags with large print make it easy to strike up conversations with new people or those you may have met at other conventions. As a person with hearing loss, I find name tags one of the most gratifying aspects of convention. I am bad at hearing names and bad at remembering them, which makes it hard to initiate a conversation with someone new, and sometimes even with people I know quite well, when the mind balks at remembering. Name tags do the work for me.

Almost everyone at Convention is hard of hearing, and accommodations are provided as a matter of course.  It’s fun – and also something of a relief – to be the norm for a change. Next year’s Convention is in Rochester, N.Y., home to what may be HLAA’s largest chapter as well as the Rochester Institute of Technology and the National Technical Institute for the Deaf. If any city in America can be said to specialize in hearing loss, Rochester is it.

 

One Potential Way to Cure Hearing Loss

Katherine Bouton Hair Cell Regeneration, Hearing Restoration, Heroes With Hearing Loss, Research on Hearing Loss

At the end of May (May 30), a few days after Americans honored Veterans on Memorial Day, a New England biotech company announced that it had received a grant from the Department of Defense to research a therapeutic opportunity that may help reverse hearing loss.

Cochlear hair cells_Credit- W. McLean
Cochlear Hair Cells. Credit:W. McLean

A 2015 study of almost 50,000 soldiers showed that peak noise levels in combat can reach 180 dB. Combat veterans have a 63% increased risk for hearing loss. Two and a half million veterans have service-connected hearing disabilities.

Clearly there is a need for treatment.

Frequency Therapeutics based in Woburn, Mass., and Farmington, Ct., announced that it had received a $2 million grant from the Department of Defense to investigate the restoration of hearing after noise-related damage as a result of military service-related injuries.

Frequency’s Progenitor Cell Activation, or PCA Regeneration, technique, uses a combination of small-molecule drugs to stimulate inner ear progenitor cells to multiply and create new hair cells. Hair cell regeneration happens spontaneously in fish and birds, but not in mammals.

Humans are born with only 15,000 hair cells in each ear and do not develop any more after birth. Damage to these hair cells over time results in a loss of hearing. Figuring out how to make regeneration happen in mammals would be a major step towards finding a cure for hearing loss, and this goal is being pursued by others in addition to Frequency.

In December, Frequency announced the completion of the first in-human safety and tolerance study of its proprietary drug combination, FX-322. (You can read more about it here.) The drug is injected into the inner ear using a standard intratympanic injection, with the patient awake.  The Phase 1 trial was conducted at Victoria Eye and Ear Hospital in Melbourne, Australia, on 9 adults with severe to profound sensorineural hearing loss who were scheduled for cochlear implant surgery 24 hours after receiving the injection.

In the press release announcing the DOD grant, Frequency noted that the PCA Regeneration platform targets the root cause of disease without removing stem cells from the body. This avoids issues that can develop with traditional stem cell or gene therapy, which can affect cells other than those targeted. Frequency’s FX-322 awakens the dormant progenitor cells already in the ear, initiating cell division and differentiation to repair the damaged hair cells.

Frequency hopes this technique can be used elsewhere in the body as well, to restore healthy tissue, and it has a number of other programs in development including preclinical research in muscle regeneration and type 1 diabetes. Frequency plans to initiate a Phase 2 trial for hearing regeneration in the U.S. later this year.

This grant applies only to military personnel with service-related hearing loss, although of course if the technique is found to work it would be available to others with sensorineural hearing loss. More than 48 million Americans of all ages have some degree of hearing loss.

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This study is one of many efforts to find a biological cure for hearing loss. I will be writing about others in the coming months. If you are a researcher with relevant information please email me at katherinebouton@gmail.com

 

The Noise of War

Katherine Bouton Healthy Hearing, Heroes With Hearing Loss, Veterans with hearing loss

This Memorial Day, as we honor veterans with parades and flags and, yes, barbecues, we should remind ourselves of the toll that war takes on hearing.images

Two and a half million veterans have service-connected hearing disabilities. Tinnitus is the number-one claim for all service related disability, with more than 1.5 million veterans receiving disability benefits for it. Another million receive benefits for service-related hearing loss.

Master Sgt., Donald Doherty, a retired Marine and Vietnam veteran who is now the Chair of the Board of Trustees of the Hearing Loss Association of America, lost his hearing as a result of gunfire and artillery noise during his 1965-66 tour in Vietnam. He has worn hearing aids since June 1970. He recently retired from the Department of Veterans Affairs after 25 years of service.

Doherty is a member of “Heroes with Hearing Loss,” supported by HamiltonCapTel. Heroes with Hearing Loss is group of veterans who hold interactive workshops to help veterans and their families come to terms with hearing loss and find solutions. You can follow them on Twitter at @HWHLVeterans.

Hearing loss is even more an invisible disability in the military than it is elsewhere. Among veterans it is often overshadowed by other injuries. But as Heroes with Hearing Loss notes, hearing loss and other injuries are  “intertwined both physically and emotionally — as a trigger, a constant reminder or an everyday frustration. It is a very unique and personal challenge for many veterans.” The website has a useful list of resources and web addresses. 

For the past several years the group has held a packed workshop at HLAA’s annual convention, which will be held this year June 21-24 in Minneapolis. I wrote about their 2014 presentation in “An Invisible War Wound,” published on November 11th, 2014, Veterans’ Day.

“Marines — and anyone in the armed forces — have been instilled with a sense of pride, the need to act independently, to do it yourself. It’s a sign of weakness if you reach out for help,” Doherty said at that event. Eventually, you realize it’s affecting “not only yourself but everyone around you.” Heroes with Hearing Loss helps veterans accept help.

Captain Mark A. Brogan, Ret., was one of the speakers that year. He was injured in a suicide bomb attack while on active duty in Iraq in 2006, sustaining a severe penetrating head injury, multiple shrapnel wounds, and a nearly severed right arm. He spent months in a coma at Walter Reed Medical Center. It was not until his traumatic injuries had been treated, he said, that he began to be aware of his hearing loss and its permanency.  He also began to realize how hearing loss and TBI were entwined.  The part of the brain that controls speech perception was injured in the blast, he said, and that damage combined with physical injury to the ear to make speech difficult to understand. He knew he needed help, but like many in the military asking for help was difficult.

HLAA was founded in 1979 by Rocky Stone, who also suffered service-related hearing loss. HLAA continues to honor and offer resources for veterans, on both the national and chapter level. Mark Brogan joined the Knoxville, Tenn., chapter: “It’s just good to get with  others who have the same type of disability,” he says.

To see some of the ways HLAA is involved with veterans nationally, go to HLAA’s website, or just click through directly to “Veterans.”

For more information about living with hearing loss, see Katherine Bouton, Amazon.com.

Debunking the Stigma of Age

Katherine Bouton Hearing Aids, Hearing Loss and aging

Whenever I give talks, there’s one Power-Point slide I use that surprises people. That’s because it directly contradicts the notion that hearing loss is something for the elderly.

As this graph shows, hearing loss is for all of us, male or female, at any age.

Slide05

The majority of people first realize they have hearing loss between the ages of 20 and 59. That’s especially true for men: 64 percent. And it’s close to true for women: 50 percent. This survey was based on self-report, so we don’t know if they “developed” hearing loss at a certain age. More accurately, they first noticed it at a certain age. People are notoriously slow to recognize hearing loss. A study using audiologic metrics would probably find even higher numbers.

So, 64 percent of men with hearing loss first knew they had it between the ages of 20 and 59, and 50 percent of women did. Add those whose hearing loss was detected before the age of 20, and you’ll find that that 79 percent of men had hearing loss by age 60, as did 70 percent of women.

So why do we associate hearing loss with aging? Why is this stigma so powerful?

The elderly do develop hearing loss: But new hearing loss over the age of 60 constitutes a much smaller percentage of the total than those who knew they had a hearing problem when they were younger.  Where does this age=hearing loss idea come from?

Hearing tends to decline with age, so the loss among the elderly is on average more severe than it is in younger people. This prompts people who have had untreated hearing loss for decades to finally get hearing aids.Slide13

Those we notice wearing hearing aids are usually old. This 2012 graph shows that approximately 15 percent those over 80 who need hearing aids have them. It’s not a large number but it’s a whole lot larger than those wearing hearing aids who are younger than 70.

A huge majority of elderly people have hearing loss, and among them a fair number wear hearing aids. This leads to a natural association of hearing loss with aging. Look at the top graph again. The majority of those with hearing loss developed it before they turned 60.

Hearing loss isn’t just for the elderly. So let’s dispense with that stigma of age and take care of our hearing. Get hearing aids!

 

 

 

Not Much of a Joiner?

Katherine Bouton #HLAA., effect of #hearing loss on medical care, Healthy Hearing

NYnewyorkcitychapter

“I’ve never been much of a joiner.”

I was encouraging an acquaintance with hearing loss to come to one of our HLAA Chapter meetings. I told her about our informative programs and guest speakers. I also said the meetings were a chance to meet other people with hearing loss.

She agreed to give it a try, meanwhile explaining that she wasn’t much of a joiner and not to expect to see her often.

That’s what I always used to say too. “Thanks, but I’m not much of a joiner.”

Here are some groups I never joined: the PTA, a church, the co-op board, the block association, political action groups, yoga classes, meditation groups, group therapy, French classes, Al-anon, dog training.

I always thought I just wasn’t much of a joiner. But suddenly (how could I not have seen this before?) I realized that it had everything to do with my hearing. It’s not that I don’t like people. Or committees. Or volunteer work. Or meditation. Or a well-trained dog. I just can’t hear.

It took me a while to join HLAA. I first went to one of the annual conventions in the course of reporting for my first book. The research seminar that year was on advances in finding a cure for hearing loss, primarily through gene therapy and stem cell therapy. It was fascinating but, more important, I could “hear” it. I could hear it by virtue of the live captioning and the hearing loop that had been installed for the event.

Someone I met there invited me to come to a chapter meeting back in New York. I’m not really a joiner, I said, but come September I did show up at a chapter meeting. Captions! A hearing loop! A really interesting program, with a panel of audiologists talking about hearing strategies.

What I could not do then and still cannot do is join in the socializing before and after the formal program. Luckily we have name tags so I know who I’m talking to, which is a tremendous help. But a substantive conversation is out of the question. Just as I always did before I told people I had hearing loss, in the old days of denial, I nod and smile and ask encouraging questions. But if you’re reading this, and you’ve tried talking to me at a meeting, it’s possible I haven’t heard a word. Follow up with an email!

I’m open about my hearing loss. In fact, I joke that hearing loss has become my profession. But there are certain circumstances that just don’t work for me. One is social time at our chapter meetings. Another is exercise class, which I will write about in my next post.IMG_3613

The photo at left was taken at last year’s New York Walk4Hearing, an annual event that will be held this year on September 23. If you’re not sure you want to try a chapter meeting, come to the Walk. No need to register. Details on our website.