How do over-the-counter (OTC) hearing aids compare to prescription hearing aids?

Answer:

There are three main types of hearing devices in the U.S. – prescription hearing aids, over-the-counter (OTC) hearing aids, and personal sound amplification products (PSAPs). There are pros and cons to each, as shown in the comparison table below. In short, all three can amplify sound, but only the first two are specifically for people with hearing loss and allow for improving hearing of specific ranges of frequencies.

OTC hearing aids is the newest class of products. They are for people with mild to moderate hearing loss and are expected to be available starting in October 2022. They may be very similar to prescription hearing aids and are estimated to save the consumer over $2,800 per pair, largely because they are fitted and programmed (using an app) by the user, rather than by an audiologist. This savings is expected to make hearing aids more widely accessible, as many insurance policies, including Medicare, do not cover hearing aids, and those that do typically have deductibles, co-insurance, and/or co-payments.

Note that people with severe hearing loss who can neither hear nor discern conversation, as well as children and people who are cognitively impaired, should only consider prescription hearing aids. Also, it is best to be checked by a medical doctor before you decide on which type of hearing device to purchase, in order to rule out simple fixes (like earwax) or underlying medical issues that can be addressed, particularly if your hearing loss has come on recently, you’re having pain in your ear, hear ringing or buzzing, or you’re experiencing vertigo.

As OTC hearing aids come to market, ConsumerLab will update this article with more product-specific information. In the interim, you may want to read a review of several existing products published by The New York Times Wirecutter (August 26, 2022).

PSAPs (personal sound amplification products)

It turns out that some PSAPs are just as good as a prescription hearing aid, while others are not, according to independent tests comparing the prescription hearing aid Oticon Nera 2 to the following PSAPs: Sound World Solutions CS50+, Soundhawk, Etymotic BEAN, Tweak Focus, and MSA 30X Sound Amplifier (Reed, JAMA 2017).

In the study, 42 older men and women (average age 72) with mild to moderate hearing loss were tested for hearing accuracy with no hearing device and with each of the PSAPs and the prescription hearing aid. Among the personal sound amplification products tested, the Sound World Solutions CS50+ and Soundhawk were the most effective, with the researchers finding just 1 and 1.8 percentage point reductions in accuracy, respectively, compared to the Oticon Nera 2 prescription hearing aid. Two of the other PSAPs were 4 to 7 percentage points lower than Oticon Nera 2 in hearing accuracy, and one, MSA 30X Sound Amplified PSAP, which cost only $30, came in much lower — just 65.3% accuracy — as shown below (as indicated in the table, some of the products in this study are no longer available).

Although there were some limitations to this study (i.e., the small number of participants and testing was conducted in a controlled environment, which may not represent all real-life auditory settings), the findings suggest that certain PSAPs offer a quality alternative to their costlier, prescription counterparts.

Source: (Reed, JAMA 2017)