Tuning in to hearing aids

From: CBS MarketWatch - Sep 2, 2004

Digital, disposable options offer consumers more choice

By Kristen Gerencher, CBS.MarketWatch.com

SAN FRANCISCO (CBS.MW) -- For those who strain to hear people speaking or to tune out background sound, seeking help from a hearing aid is not always an attractive option.

Some people think of hearing aids as cumbersome devices that draw too much attention or simply don't fit their lifestyle. But new models are changing that image, and digital technology is enhancing functions as well.

A host of new products, including some less-costly "entry level" hearing aids, is arriving just as baby boomers approach the age at which hearing begins to decline, hearing experts say.

About 28 million Americans say their hearing is a problem some or all of the time, and half could benefit from amplification, according to the Hearing Industries Association, a trade group of hearing aid manufacturers and components-makers. But only 6 million use hearing aids.

Because many people can accommodate mild to moderate hearing loss, it takes eight years on average before they seek assistance, association president Carole Rogin said.

"Hearing loss is pretty gradual in its onset and pretty insidious in its growing severity," Rogin said. "People can adapt for a long time."

About 80 percent of hearing aids purchased in the United States are placed in the ear, come in an array of sizes and are custom-made. Behind-the-ear models account for 20 percent of sales.

Once people recognize they have a loss, attempts to hide it often backfire, said Dr. Thomas A. Powers, director of audiology and strategic development at Siemens Hearing Instruments in Piscataway, N.J.

"The hearing aid is always less conspicuous than the hearing loss," Powers said. "If you're constantly asking someone to repeat because you can't hear well, that becomes obvious."

Financial, technical considerations

Health insurers typically don't cover the expense, which can run $1,000 to $1,500 per ear for a linear, analog version and up to $4,000 for a digital hearing aid, including services to fit and maintain the device, Rogin said. Prices vary based on style and circuitry.

"Like glasses used to be, it's viewed as an assistance device and generally not covered," she said. "We think that will probably change aggressively as the 78 million baby boomers move into the age range where living in an amplified society starts to take a toll on your hearing."

A bill in Congress would provide a $500 tax credit per hearing aid purchased by hearing-impaired adults and dependent children once every five years.

As technology improves, more consumers are gravitating to advanced products, with 70 percent of sales going for "high performance" aids, which are programmable digital and analog devices that allow the user to modify the signal, Rogin said.

Though most digital products have built-in volume control, some manufacturers are moving to give consumers control, said Dr. William Luxford, medical director of the House Ear Clinic, an affiliate of St. Vincent Medical Center in Los Angeles.

Still, it's ease of use and not volume control that's targeted in promotions for the Songbird 400-hour digital disposable hearing aid,which debuted last year for people with mild to moderate hearing loss. It's a one-size-fits-all alternative that's available over the counter and has a built-in battery that expires after 400 hours or 90 days of use, whichever comes first. A single pack sells for $69.99, and the products will be available at CVS drugstores in November.

Setting expectations

Of course, hearing aids are not a solution for all hearing losses. The first step is seeing a doctor or audiologist to assess the problem, its cause and its potential for medical or surgical remedies such as cochlear or other implants, Luxford said.

If hearing aids are indicated, the doctor often refers the patient to a dispenser, someone typically licensed by the state to fit and train people in how to use them, he said.

The dispenser generally offers several choices, but patients need to understand that even high-end hearing aids have limitations, Luxford said.

"There are going to be settings where even the person who has normal hearing cannot expect to hear because there's too much interference," he said. "When people have a hearing loss and they receive this very expensive device, they expect to be able to hear even in settings where they really shouldn't hear."

"With the elderly population, there is also the problem of how the ear processes the information," Luxford continued. "The pathology may not be in just the ear and how it receives information, the intensity problem. It may be how it gets processed."

The majority of new patients use digital hearing aids, though some may prefer analog devices for simple hearing losses, he said. For losses that occur across all frequencies but with good speech understanding, "you probably could get by with a less-expensive analog hearing aid."

Guidelines and questions to ask

Hearing aids have four components: microphone, amplifier, loud speaker and battery, Powers said.

At Siemens, (SI: news, chart, profile) custom aids come in three styles -- in-the-ear (ITE), in-the-canal (ITC), also called half-shell, and micro or completely-in-the-canal (CIC.) Directional technology is available on select custom and behind-the-ear models, and consumers who need to distinguish background sounds may find a better fit with ITE or half-shell models.

Consumers should look for aids that match their hearing needs and listening situations, Powers said. If they're working and socially active, they may require directional microphones or noise reduction features whereas someone who's more housebound may only need amplification, he said.

Among other factors consumers are wise to consider, according to experts:
1. Ask about a trial period. Most hearing aids come with a grace period of 45 to 60 days during which dissatisfied consumers can return them for a full refund, Luxford said. About 20 percent of buyers return the devices because they don't fit their needs.
2. Life span. Most hearing aids last five to seven years, Powers said.
3. Maintenance of batteries and daily cleaning. Battery life tends to be about two weeks on average across all instruments, with behind-the-ear and in-the-ear aids often lasting three weeks, he said. Completely-in-the-canal models tend to have the shortest battery life -- about a week - because the batteries are smallest and have the least capacity. Consumers are often surprised batteries don't last as long as those in their watches, Powers said. "You're taking a fairly sophisticated audio system and downsizing it to something that can work on a 1.3 volt battery and fit into someone's ear." Expect to spend about $50 to $75 a year on batteries, which can be replenished via mail order.
4. Dexterity. People with vision problems or arthritic hands tend to prefer hearing aids with larger batteries because they're easier to maintain.
5. Warranty. Most are sold with a one-year warranty against defects in manufacturing, Powers said. Some dispensers offer second- and third-year warranties for about $250, he said.

Kristen Gerencher is a reporter for CBS.MarketWatch.com in San Francisco.

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