Recommended reading

Hearing Health & Technology Matters
October 24, 2012

By David H. Kirkwood

I read an article in The New York Times yesterday that I think anyone involved with hearing aids ought to read. It’s not that I think you’ll enjoy it. Probably you won’t, especially if you manufacture, market, or dispense hearing aids in the traditional manner. But you should still pay attention to what it says.

As for hearing aid users, either current or prospective, I suspect much in the piece will ring true to you.

But, however you feel about it, the article raises important questions and issues that the hearing care industry can ill afford to ignore.



Tricia Romano

The author of “The Hunt for an Affordable Hearing Aid” is Tricia Romano, a New York-based journalist who has suffered from hearing loss since age 5 and has worn a hearing aid in her better ear for 30 years. Romano presents a first-hand account of her experiences when she decided the time had come to replace her failing 10-year-old instrument.

Returning to the hearing aid market after a decade away, she discovers that “purchasing a hearing aid had become even more difficult and confusing than buying a new car–and almost as expensive.”

The parallel to shopping for cars continues when Romano goes into an office of a national chain. There, she reports that the “salesman” (her term) “bristled” when she asked him what was available for $1000. He showed her only three models, which ranged in price from $1600 to over $2000. He likened the higher-end device “to listening to an orchestra” while comparing the sound of the less advanced model to that of a car stereo.



Dissatisfied by this choice, the writer continues her search for a hearing solution that fits her budget. She interviews executives of companies that sell hearing aids online for as little as $400. Romano doesn’t push the online alternative, and she quotes Deborah Carlson, president of the American Academy of Audiology, who explain the benefits to consumers of paying the cost of being custom-fitted by a well-trained professional.

However, I suspect Times readers will find especially compelling—and disturbing—some points made by two executives of online hearing aid companies. Asked why hearing aid prices keep going up while other electronic devices get cheaper, Russ Apfel, CEO of Audiotoniq, says it’s because, “The hearing aid industry uses every new thing, like digital or a new algorithm, to raise prices.” Apfel, an engineer who has developed hearing aid technology, estimates that the actual cost of manufacturing one hearing aid is no more than $100 in most cases.

Pat Freuler, founder of Audicus, contends that many people don’t need an advanced hearing aid. He says, “For someone with mild to moderate hearing loss, the average hearing aid today is completely over-engineered.



In case she hasn’t sufficiently outraged manufacturers and practitioners, Romano ends her quest for an affordable hearing aid at Costco, a name that I’ve heard many practitioners use as an epithet. She reports that hundreds of Costco stores around the country sell hearings aids ranging in price from $500 to $1300. They are made by major manufacturers and fitted by licensed audiologists and hearing aid specialists.

While the writer was unhappy with the first hearing aid she bought from Costco for $950, nearly a year later she was able to trade it in for another model at a different Costco store at no charge. She is now satisfied—for the price she was looking for.



Although it would be a mistake to make light of this article, it’s easy enough to do so. After all, one can point out, it’s just one hearing aid user’s anecdotal report. Ands to say that it costs only $100 to build an advanced hearing aid is close to meaningless, since (as Romano notes) it fails to take into consideration all the costly R&D required before the first hearing aid can be sold. The parallel between hearing aids and other high-tech devices breaks down because only hearing aids are custom-designed for a particular consumer.

The margin between the wholesale and the retail price of hearing aids is large, but has to be. That’s because it needs to cover the practice’s overheads and still leave enough over for the owner and/or employees to live on (and pay back the loans they took out to get their AuD).

But valid though these excuses/explanations for the high cost of hearing aids may be, increasingly consumers with hearing loss are not going to accept them. There is so much information about less expensive alternatives out there on the web, in print ads, and in articles like this one in the Times, that a growing number of people who need hearing help will go outside the traditional channels to get it. Or, more often, they will simply continue to hear badly—as has always been the case with a majority of the hard-of-hearing population.

Am I suggesting that everyone go work for Costco? No, but I think those who do probably deserve more respect than they get. And I’m certainly not saying that companies should stop making top-of-the-line products or that professionals shouldn’t try to sell them.

However, I do believe that people like Tricia Romano, who need hearing help and can’t afford or don’t want to pay $2000 or $3000 per hearing aid, shouldn’t find it so difficult to buy a professionally dispensed product in their price range. While I don’t expect most manufacturers or practitioners to push the low end of their product line, they should let their customers know that it’s available to help those consumers who are looking for it.

I urge all of you to read the article and then share your views with me.


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  1. I have worked at Costco for 21 years and have been selling HA’s at Costco for 14yrs as a Hearing Aid Specialist. It has been my experience that Costco has worked diligently with our manufacturers to provide our members with the BEST Advanced and Premium level technologies. I personally prefer the Bernafon and ReSound devices, more so then the Rexton-Kirkland models. It is true that retailers have greater overhead expenses then a Costco location, HOWEVER, the HA business, in general, has been corrupt and deceitful since the beginning…especially since the Audiologist/Specialist battle that broke loose in the 70’s.. Audiologists have NEVER liked seeing HA Specialists earn as much as, if not, substantially more money. Costco allows for a much more reasonable price point with substantially better warranties and follow up service then almost every retailer.. its time for the private sector to get down to a more reasonable and affordable level or watch this profession leave them behind. That is the hard truth.

  2. The New York Times author’s experience is very representative of what my hearing aid buying experiences have been during the past 20 years (with several providers).

    After 40 years of wearing hearing aids, I have come to the conclusion that the current distribution model needs to be restructured. I can afford to pay top dollar every few years for a new pair of instruments. However, I look around and see that 80% of my fellow citizens who may benefit from hearing amplification are not even meaningfully addressed by the economics of the current hearing aid distribution model.

    Any other semi-regulated industries with FDA government protections and low consumer penetration rate over 4 decades would be considered inefficient and would restructured.

    As a result of similar experiences noted in the NYT article, I have chosen to purchase my aids in alternative channels. With out of pocket costs which are 80% less than the traditional sales channel, I have found non-Big 6 instruments to be ‘just good enough’. As a result, I spend my money for new hearing aids in alternative, non-traditional channels. Also, I encourage experienced hearing aid purchasers to consider doing the same.

  3. A study presented recently at the American Academy of Otolaryngology – Head & Neck Surgery Foundation Annual Meeting in Washington, D.C. shows that the MD HearingAid line, which is designed by a physician offers a reasonable low-cost solution to those who are not using hearing aids or other amplification devices because of cost concerns. This may be used in your blog if you wish.

    Thank you, Gary Grasso, Doctor’s P.R. :

    Editor’s note: The article that Gary Grasso refers to is available at

  4. I have been introduced to Sam’s hearing aid department in mid-2013. After 25 years of physician audiologist offices and/or HA specialists I am left with a not-good feeling
    about the experiences. Is there any good reason that I should not try the Sam’s alternative?

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