Over-the-counter hearing aids to be sold nationwide to make the devices more accessible and more affordable.
Pete Couste said it was his wife who first noticed that he was turning up the TV louder than she liked.
“I couldn’t hear the words in movies as much anymore,” admitted Couste, who lives just outside Washington, DC.
Watching TV isn’t Couste’s only problem. In his church choir, he can’t always hear his part and get the pitch right. It’s also affected his work at the Fire Safety Research Institute, a nonprofit that generates safety research. The 61-year-old said he feels less effective judging audio quality when his team makes their life-saving videos for firefighters.
“It is affecting all parts of my life,” he said.
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He saw an audiologist who said he needed hearing aids, but they would have cost him more than $6,000. “I thought, ‘Maybe this can wait,'” Couste said.
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That was seven years ago.
The wait may be over for Couste and millions of other Americans. On Monday, for the first time, adults with mild to moderate hearing loss in the US will be able to buy over-the-counter hearing aids. Those who are under 18 or who have severe hearing loss will still need a prescription.
Help for millions
The US Food and Drug Administration announced the long-awaited rule change in August, ushering in options that should be cheaper and possibly even better.
Now, instead of getting a prescription and having a custom fitting with a hearing health professional, adults can buy hearing aids directly from a store or online. Some doctors estimate that 90% of the population with hearing loss could benefit from these over-the-counter devices.
Experts say the move is a “game-changer.”
Over-the-counter hearing aids are a great option for people in the mild-to-moderate stage of their hearing journey.
“We’ve been working for years for affordable and accessible hearing health care,” said Barbara Kelley, executive director of the Hearing Loss Association of America. “We’re really looking forward to Monday.”
Couste is certainly not alone in forgoing hearing aids because they were too expensive, Kelley said. Only about 16% of the tens of millions of people with hearing loss use a hearing aid, according to the National Institute on Deafness and Other Communication Disorders.
The number of people with hearing loss is substantial. About 1 in 8 people in the US ages 12 and older has hearing loss in both ears, and the rate increases significantly with age. About a quarter of people 65 to 74 have hearing loss, and that goes up to 50% around age 75.
On average, people spend at least $4,000 out of pocket for devices for both ears, according to a 2020 study published in the medical journal JAMA. Prices can vary: Large retailers may offer a pair for about $1,400, but some can cost as much as $6,000 per ear, depending on the technology.
The FDA rule allowing for over-the-counter hearing aids didn’t change how the devices are covered. While private insurers pay for treatment after the loss of a limb or even cover the cost of Viagra, most do not cover hearing aids. Most Medicare plans won’t pay for them, either. Only about half of state Medicaid programs do.
More competition, more advances
Until now, five companies have controlled 90% of the global marketplace for hearing aids. That kind of consolidation meant there was little price competition.
With the change, many more companies are expected to enter the market. Experts say that existing manufacturers will also develop lower-cost over-the-counter devices in addition to their current offerings.
On Monday, some familiar companies from the world of audio will be selling hearing aids.
Chelle Wyatt wears her hearing aid Friday, April 15, 2022, in Salt Lake City. People with hearing loss have adopted technology to navigate the world, especially as hearing aids are expensive and inaccessible to many.
Sony has a couple of models that pair with an app that lets users personalize settings and find additional support. The CRE-C10 sells for $999.99 and has a battery life for up to 70 hours of continuous use. The CRE-E10 has more of an earbud-like design and a rechargeable battery; it is Bluetooth compatible to stream music or audio. It will be available for $1,299.99 on the Sony website and at Amazon, Best Buy and other retailers.
Bose also teamed up with Lexie Hearing to offer the B1 model for $899 a pair. The B2, for $999, adds a rechargeable battery that works for up to 18 hours. Both models are Bluetooth-enabled, can be tuned by the wearer and pair with a mobile app for support. They’ll be sold online, at drugstores and at stores like Best Buy.
Best Buy says that nearly 300 of its stores will offer a “hearing experience,” which will include about 10 over-the-counter hearing aids and PSAPs, or personal sound amplification products. Those enhance sound but don’t need to meet FDA standards, unlike hearing aids, which have to meet the FDA’s high standards for labeling, manufacturing and safety, like other medical devices.
Best Buy is encouraging customers to take a hearing assessment on its website before coming into the store to work with trained associates to pick out a new device.
Why hearing aids matter
Hearing aids aren’t just nice to have; they are essential for physical and mental health.
People with hearing loss who do not have hearing aids are more likely to report poor health overall, and they are less likely to leave home or exercise, studies have found.
There’s a link between hearing loss and general frailty and an increasing risk of falls, which are the second leading cause of unintentional deaths worldwide, according to the World Health Association.
Several studies have also found an link between hearing loss and poorer mental health and psychosocial health.
Hearing loss can lead to depression, loneliness and isolation — even dementia.
With hearing aids becoming easier to access, “I have a big smile on my face right now,” said Dr. Frank Lin, director of the Cochlear Center for Hearing and Public Health. He has been consulting with the government on this issue for eight years.
Lin said there has been little innovation in this space because of the way the market has been regulated.
“In 1977, because of the technology at the time, the only way for hearing aids to be safe and effective is if they were programmed and fitted and professionally adjusted by a licensed provider,” he said. “But the market and that technology has changed dramatically.
“This will allow companies like Samsung, Apple, Google — companies that are already making innovative earbuds — they can now enter the market. They really couldn’t before.”
What to look for
Kelley said that if you plan to buy an OTC hearing aid, make sure to read the return policy. The FDA did not require companies to offer one, as Kelley’s group pushed, but any return policy should be listed on the package.
Check how long you have before you can return them, too. Hearing aids are different than glasses; it can take your brain up to four weeks to adjust to hearing in a new way.
Test them in different circumstances over a few weeks to see whether they’re the right fit. Do they help in a crowded room, or are they better at work? It’s not one size fits all.
Couste said he will check with his insurance company to see whether it will pick up any of the cost of an OTC device. But finally, after all these years, he thinks he’ll soon be able to hear better.
“I am looking forward to it,” Couste said. “I truly am.”
Over 45? Here’s how often you should be screened for these health conditions
Health screenings 101
No one wants to run into a health problem that they could prevent. Correctly timed screening tests can detect diseases or health disorders before symptoms show, helping you get ahead of problems earlier. They also give you a deeper ownership of your own state of well-being.
Early detection helps inform lifestyle changes and monitoring. These changes reduce the risk of disease and can significantly increase your chances of finding effective treatments. For example, cases of colorectal cancer in the United States have been declining by approximately 1% every year due to better awareness of screening and lifestyle choices—though this is largely a reflection of adults over 65. Rates for adults aged 50-64 have been rising, and the generally advised age for colonoscopy has dropped from 50 to 45 in recent years in hopes that early detection will also improve outcomes.
Generally, doctors advise people under 50 with no medical problems to have a check-in visit every three years to make a general assessment of health. Yet, about half of Americans have skipped or delayed medical care because the cost is a significant barrier. Other reasons are lack of awareness, insurance coverage issues, and lack of trust in service providers.
About eight out of every 10 adults in the United States visited a doctor as of 2020. The frequency of their visits depends on age and underlying health status. While this figure is encouraging, there remains a significant gap in screening frequency for older adults for several health conditions of concern. In an effort to plug that information gap, Guava Health outlines how frequently you should be screened for 10 health conditions and diseases, citing research from the Preventative Health Task Force, the Centers for Disease Control and Prevention, and medical journals.
Diabetes
Diabetes is a deceptively common disease; about one out of five people with diabetes are unaware that they have it. This makes screening for diabetes very important. Among U.S. adults, it is the leading cause of kidney failure and new cases of blindness, and is closely associated with increased risks of cardiovascular disease, nonalcoholic fatty liver disease, and nonalcoholic inflammation of the liver.
The U.S. Preventive Services Task Force recommends screening every three years. This is especially advised for adults over 35 or people with one or more risk factors — particularly those who have obesity or are generally overweight.
To make a diagnosis, a doctor takes a blood sample for an A1c test, which shows the average blood sugar level for two to three months.
High cholesterol
High blood cholesterol increases one’s risk of heart disease, the leading cause of death in the United States, as well as stroke. Unfortunately, high cholesterol is asymptomatic, which makes regular blood screening crucial to its detection and treatment.
Children and teenagers should get their cholesterol levels checked at least once when they’re between ages 9 and 11 and then every five years thereafter. Doctors recommend that adults check their cholesterol levels every four to six years. People with conditions like diabetes or heart disease and those with a family history of high cholesterol are advised to get screened more frequently.
Chronic kidney disease
According to the Centers for Disease Control and Prevention, around one in seven American adults have chronic kidney disease. More alarming, the CDC estimates as much as nine of 10 adults do not realize they have the disease. Blood pressure monitoring, urinalysis, and blood tests help a doctor estimate a patient’s glomerular filtration rate, or how well your kidneys are filtering waste.
The United States Preventive Services Task Force reported that extra research is needed to recommend routine screening. Other sources like the National Kidney Foundation suggest annual tests.
Colon cancer
In the United States, colon cancer is the third most commonly diagnosed cancer in both men and women each year. To detect and prevent colon cancer early, routine screening should start at the age of 45. However, people with inflammatory bowel disease, a history of colon cancer, or a genetic disposition toward colorectal disease should start screening earlier.
The United States Preventive Services Task Force suggests screening methods like stool tests, a CT colonography, a flexible sigmoidoscopy, or a colonoscopy.
Lung cancer
Lung cancer accounts for one in every four cancer deaths, making it the most common cause of mortality among cancer patients. According to the American Cancer Society, those with a smoking history — including those currently smoking or those who have quit in the last 15 years — should screen yearly with a low-dose CT scan through age 74. Those with a 30 pack-year smoke history are also advised to screen — a pack-year is defined as one year of smoking one pack of cigarettes each day.
The United States Preventive Services Task Force gives a similar recommendation. They recommend screening for adults between the ages of 50 to 80 who have a 20 pack-year history.
Breast cancer
In the United States, breast cancer is the most common cancer diagnosed in women after skin cancer, which is generally quantified across multiple skin cancer forms. Breast cancer is commonly diagnosed in women between the ages of 55 and 64. According to the U.S. Preventive Services Task Force (USPSTF), age is the most important risk factor.
Based on this, the USPSTF recommends women aged 50 to 74 with an average risk for breast cancer have a mammography once every two years. Other organizations suggest screening once every year or once every two years for women aged 50 and above. As women get older, the number of breast cancer deaths prevented by screening rises. Mammography and Magnetic Resonance Imaging (MRI) are the most common screening tests for breast cancer.
Cervical cancer
Human papillomavirus (HPV) is responsible for nearly half of all cervical cancers, and 80% of sexually active women will have this virus. This is the basis of the recommendations given for screening women for cervical cancer. The most common test performed to screen for cervical cancer in women is the Pap test, or Pap smear.
As reported by the National Cancer Institute, the American Cancer Society (ACS) updated recommendations for cervical cancer screening in 2020. ACS recommends cervical cancer screening with an HPV test every 5 years for anyone with a cervix from age 25 to age 65. If HPV testing alone is not available, an HPV/Pap co-test every 5 years or a Pap smear every 3 years is recommended. One significant change to the ACS’ recommendation here is that the prior recommendation for a Pap test every three years for women ages 21-24 was removed.
High blood pressure
High blood pressure, also called hypertension, tends to have no symptoms and a diagnosis must be made by a medical professional. Testing for high blood pressure is important because the condition increases the risk of stroke. The American Heart Association considers blood pressure numbers within normal range if it measures 120/80 mm Hg — 120 is how much pressure your blood pushes against your artery walls as it beats and the 80 indicates the pressure when it rests between beats.
The association recommends screening tests for adults 20 years and older with blood pressure at or below the normal range every two years, with the frequency of follow-up depending on one’s risk level. More frequent screening tests are recommended when blood pressure is higher than normal range. An at-home kit is an efficient tool for monitoring your blood pressure—especially if you have high blood pressure.
Sexually transmitted diseases
This category comprises a number of diagnosable diseases, including but not limited to gonorrhea, chlamydia, hepatitis B and C, HIV, and syphilis. CDC recommendations vary for each. In general all people 13-64 should be tested for HIV at least once. Sexually active women younger than 25 years should be tested for gonorrhea and chlamydia every year, and pregnant women should be tested for syphilis, HIV, hepatitis B, and hepatitis C starting early in pregnancy, with additional tests as needed depending on risk factor. CDC further recommends all sexually active gay and bisexual men be tested yearly for syphilis, chlamydia, and gonorrhea, as well as HIV.
Overall in this category, screening recommendations are based less on age bracket than behavior, therefore regardless of age, adults over 45 should follow CDC guidelines based on their individual lifestyles.
Osteoporosis
Osteoporosis is the most common bone disease in the United States and is most prevalent among women. It is brought on by low bone mass that leads to weakening of bone tissue, structure, and strength over time. A study reported by the National Institutes of Health showed that women 65 years and older with healthy bone density can have a screening interval of 15 years after their initial test. According to the United States Preventive Services Task Force, while there is limited evidence of the advantages of screening for osteoporosis in males, bone measurement testing to prevent osteoporotic fractures in women is strongly recommended. Other factors that can influence screening frequency include age-specific diseases or when patients take certain medications.
This story originally appeared on Guava Health and was produced and distributed in partnership with Stacker Studio.
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