Exploring the benefits of direct-to-consumer hearing aids

By Anne Riker Garlington

Dr. Hollea Ryan
Dr. Hollea Ryan

In 2022 the U.S. Food and Drug Administration’s ruling on over-the-counter hearing aids for mild to moderate hearing loss went into effect, making it possible, for the first time, for consumers to buy hearing aids directly online and in retail stores.

The goal is to lower cost and improve access to the devices, but with so many options flooding the market, it can be hard for consumers to know where to start. In honor of National Speech-Language-Hearing Month, University of Florida College of Public Health and Health Professions experts are here to share their insights.

One of the first things to consider when weighing direct-to-consumer hearing devices versus prescription, are what features you need, said Hollea Ryan, Ph.D., Au.D., a clinical associate professor and audiology program director in the department of speech, language, and hearing sciences.

“Some of the less expensive over-the-counter hearing aids offer few, if any, additional features such as Bluetooth technology,” Ryan said. “Despite these limitations of over-the-counter hearing aids, they will be helpful for some individuals. However, should a person find that the over-the-counter hearing aid is not providing the amplification they need, I would recommend they contact an audiologist to determine what other options might be appropriate.”

Dr. Molly Jacobs
Dr. Molly Jacobs

There are two distinct types of direct-to-consumer hearing devices. One is the over-the-counter hearing aid and the other is personal sound amplification product, which is intended to help people hear better in difficult listening environments, but is not approved to treat hearing loss.

Health economist Molly Jacobs, Ph.D., and PHHP colleagues Charles Ellis, Jr., Ph.D., a professor and chair of the department of speech, language, and hearing sciences; and Amber Gerasimchik, a third-year Doctor of Audiology student; along with Sterling W. Sheffield, Ph.D., Au.D., an associate professor of communication sciences and disorders at Western Washington University, recently published a study, which found that while direct-to-consumer hearing devices were helpful for mild hearing loss, they were less effective for more severe types of hearing loss.

Jacobs, an associate professor in the PHHP department of health services research, management and policy, provides three points to consider for hearing device options.

1.     Hearing tests are important.

Patients should be aware hearing is part of their overall health. While hearing loss can be age-related, it can also be a sign of many other things. Therefore, it is important to get a hearing test by an audiologist or hearing professional to verify the underlying cause of hearing loss, as well as any other health issues. Untreated hearing loss poses risks to overall health, and proper diagnosis ensures appropriate management. Those individuals with more severe types of progressive hearing loss could exacerbate their condition or receive limited benefit with improper usage.

2.     Understand the devices’ limitations.

The direct-to-consumer hearing devices are designed for adults with mild to moderate hearing loss and are made to fit the average ear. Unlike the process for a prescription hearing aid, direct-to-consumer devices are not individually fitted. As with everything else, one size may not fit all, and improper use of the degree of amplification could damage your ear. Patients should be open and honest with their health care provider if they are considering a direct-to-consumer devices. Hearing health professionals want to ensure that their patients are healthy, knowledgeable and comfortable with the decisions they make regarding hearing devices. 

3.     Cost may not be the only factor for some.

While the price of hearing aids has decreased over the past few decades, we have not seen an in-kind increase in hearing aid usage among all population groups. Our research suggests hearing aid usage is not only driven by income, but also consumers’ tastes and preferences. While aesthetics and socio-cultural norms may play a role, more research is needed to determine the factors that influence hearing aid usage among different racial and ethnic groups.