From OTC to Prescription Hearing Aids: Eargo Broadens Its Hearing Solution Offerings

Welcome to This Week in Hearing. Hello, I’m Bob Traynor, your host for this episode. An interesting one as we, as we watch the progression of a manufacturer from a company that began 15 years ago or so into the prescriptive market today, my guest is Bill Brownie, CEO of Eargo, and Kim White, an audiologist at Eargo modifying this group and their entrance into the prescriptive market. So thanks so much for being with us today, Kim and Bill. We appreciate your time, energy and effort that goes into making these kinds of interactions with our colleagues in the clinic. Thanks, Bob. We really appreciate the opportunity to be here. So great. Well, you know, and most of us don’t know, a lot of the executives and some of our colleagues that are audiologists within the industrial area. Bill can you give us an idea of your journey to become actually a CEO of one of the manufacturers within the hearing industry? Absolutely, yeah. So just reflecting on September 2024, being my 23rd year in the hearing aid business started in 2001 with a company called Hearing Planet that was just gotten started. They’d been in business a little over a year when I joined. And, you know, innovative company in terms of a new way to approach you know patients or potential patients through this thing called the Internet. Yeah. And you know, was fortunate to work with a great group of people there and help grow that business. You know, as many people know, we sold that business to Sonova back in the mid 2000s. And I continued with the company up until 2015. We worked within the Sonova organization, helped connect hearing with some contact center services, also helped Lyric over the years as they did their direct to consumer. And that was really kind of my introduction into invisible hearing aids was when I worked with the Lyric team. And the consumer response to that product was like nothing I’d seen in the hearing aid business before. So I left Sonova in 2015 decided to just explore some other things and took a year off. And then in 2016, the chairman of the board of Eargo gave me a call and said, hey, we’ve got this company called Eargo that has got a unique device out there. And I had really not known much about Eargo at the time, but did my research and I, wow, this is a very interesting company. Had come up with an invisible device similar to what I was talking about with lyric, but in a more direct to consumer fashion. So kind of pulled together my experience from Hearing Planet, dealing directly with consumers in a kind of a new way. And then ultimately the product was something that was really unique. And so I joined in 2016, help them establish their customer operations, and then ultimately progressed and took over the CEO role about a year ago. Well, it’s also kind of one of the really very first self fit products in some respects as well which is another kind of innovation that wasn’t around early on. And well, thanks, Bill. That gives us an orientation for all your vast experience, particularly with the, the area of Internet interactions and all those things. Some people think the Internet’s been around forever. The rest of us kind of know that we didn’t have it for a long time, and now that we do, it has absolutely fabulous benefits, but it’s also got a few little limitations as well, and we all know that. Exactly. Kim can you give our group and orientation to your journey in audiology that finds you now at eargo working with their transitional program? Sure. Thanks, Bob, for the opportunity to speak. I’ve been an audiologist for 30 years, which is quite shocking because I feel like I’m 27, so to have been able to help people for that long. I started out in West Virginia in an ENT clinic and worked there for several, several years, and then I had the opportunity to move into the manufacturing end of it. And I worked for Starkey for a while, and I also worked with Phonak and provided support to customers and their end users that were having difficulty with fitting. So I always kept my hands in the patient centered portion of it. And then over time, I was getting married and decided that I didn’t want to be on the road traveling from a manufacturing standpoint. So I went back into private practice and then Covid came, and living in Florida, we were shut down for quite a time. And it was really frustrating to me to not be able to help my patients. And I had some friends that worked for Eargo and was fascinated with their ability to continue to provide support to patients, regardless of the situation, because they were an Internet based company. So I was able to come to work for Eargo and work with some of the sales team and worked with patients that would call in and talk with them about their needs and their hearing loss to determine if Eargo would be a good option for them, and then have expanded on that in the prescriptive world to help kind of meld the Eargo patients that I spoke with that really loved the form factor, but really wanted that personal, in person touched to be able to put those two worlds together. Well, I think some of your work and Eargo’s work in developing this direct to consumer market had to be one of the premier groups involved in that area. And so now we have quite a direct to consumer market because of the innovations that Eargo had and others as well. So Bill, you guys began as a consumer company, kind of operated in the direct to consumer market for many years. What made you as a company strategy expand your distribution into the partnerships with individual practices and modifications of this big modification of your orientation to the marketplace? Yeah, I think one of the things that, you know, has always been my philosophy is the importance of the hearing professional in someone’s journey to getting hearing care. And, you know, when we started a year ago, you know, I think that initially the thought was it was you know, 100% direct to consumer and, and, you know, we didn’t need the need the hearing professional in the process. And I think what we learned very early on was that the hearing professional is important to the process. And so, you know, since the time of our launch kind of relaunch in 2017, we’ve been very focused on having hearing professionals do what we call an orientation call with our clients you know, our direct to consumer clients. And we found that to be very significant in terms of getting them on the right path you know, to understanding what the product can and can’t do and all those sorts of things. So that’s really been our focus up until this point, is providing sort of that remote audiology service. But what we also found is that, you know, there is a market out there for folks who want to go see a professional face to face. And, you know, I think what we learn, what we’ve learned over time is that many of our clients started with a face to face visit with a professional, ultimately didn’t, didn’t decide to continue with that journey that way, and then, and then found us and purchased directly from us and then, you know, access remote audiology. So I think it’s a natural progression for us, you know, in terms of the receptiveness of our product, you know, uniqueness of our product being, you know, virtually invisible, rechargeable, all of those sorts of things as a natural progression to now offer it to the professional channel. We’ve had tremendous response from folks who are interested in the Eargo product hearing professionals specifically. And so I think it’s a natural progression of what we’ve already been doing from a remote audiology perspective and addressing the needs of some clients that would like that face to face visit. So that’s really how we got here. Well you know, I’m sure Kim, Kim and I both can, can tell you that there are reasons why patients stay with individuals in a clinic, and there are reasons why they go search somewhere else for a lot of things. And I’m sure she and I will go along with the fact that many of them we’d like to have them go that way anyway. However maybe Kim, can you give us an idea of a little bit about Eargo’s prescription products and the kinds of differences they may have from the OTC products that you guys have been marketing over a period of time? Sure. So, as Bill had mentioned, you know, we did find that there were a lot of our OTC patients that had been into clinics. We actually completed a study that ran from October of 2022 into May of 2023, and we sent a survey to over 11,000 Eargo OTC wearers. Over 800, almost 900 people responded to it. So we had a great response and found a lot of information. And one of the things that was really surprising, but also reaffirmed what we had thought, and that was that over 2/3 of all of our OTC users that completed the survey had been to a hearing professional’s office first. And one of the other things that we found is that 80% of them said that the reason that they purchased an Eargo hearing aid was because of the form factor. They wanted something discreet, they wanted something invisible. They needed something that was open fit, and they wanted something that was rechargeable, because no patient likes a CIC that has to have a battery changed every three days. So in finding that information, as well as the fact that 70% of our patients were new users. So to be able to offer a program that gets patients in your door, new patients, 70% to purchase a product that they want, that’s appropriate for that open, fit CIC standpoint, that traditionally we as an audiologist and hearing care providers have only had a RIC. And now when we presented five pictures of the five major sizes of products, 80% said they wanted a CIC. I remember the days when everybody wanted a CIC, but it was so occlusive that it was such a problem. And when Eargo came out, it’s like, oh, my God, this really looks cool. So not to interrupt you, but it was a big problem at one time or another, I even wrote a couple of articles about the fact that there were big occlusions there. Of course Sweetow did all his omclusion stuff and all those kinds of things at that time. Here we are now with a device that’s an open fit CIC. Now, how reverse in philosophy is that? Right? Absolutely. Absolutely. And we also found that the adoption rate for an Eargo product was four years compared to a traditional prescriptive product, which is almost eight years. So it was really interesting and eye opening to us. And along that same path, we did a pilot with audiologists and said, would you be willing or interested in offering Eargo otcs? And the folks that we talked to said, yeah, absolutely, we would. We would love to do that. And what we found is when we provided them the technology and the hearing aids, nobody offered the product. Jeez. And so, as we talked deeper about it, it wasn’t because of the product. They loved the way that it sounded. They loved the way the patients love the way that they fit but as professionals, we want to have control, and with an OTC, we did not, as the audiologist and the hearing care professional did not have the ability to have that control. So what Eargo has done is develop a prescriptive line of products that gives the patient the size, the fit, the format that they want, and the hearing professional the ability to program and adjust and do real ear verification, all of the things that make them best in practice. So we were able to give the end user and the hearing professional the capability to fit our product and everybody be happier. Gives the audiologist the ability to have more access to first time users, an earlier adoption rate, and a happy patient with a size and shape that they want. Wow. Sounds like a win-win kind of a thing. Can you tell us a little about the product line itself? Kim Give us some perspective as the differences between the two. Eargo has launched two prescription products, our Eargo 7-Rx and our Eargo SE Rx. Our Eargo 7-Rx is our flagship hearing aid. It has an induction charge, so you won’t see contacts, as you can see when you compare them Eargo 7 versus the one on the right that has the two gold contacts. Other things that are different are the pedal designs. They’re a little bit different. Both are open. fit, Eargo 7 comes with different sizes, open and occluded pedals. Where the Eargo SE Rx comes with our trumpet that has a medium and a large system on there. From a technology standpoint, the eargo 7-Rx has a much more robust feedback. Excuse me, noise management system. Both hearing aids will look to adjust the noise in the channels as they appear. The Eargo 7 will look if the hearing professional has selected a different listening environment, and that environment would be more appropriate for the situation that the patient is in, it will automatically shift there, then look to reduce the noise in the channels, and then it will look to search to see if the environment is so loud that the hearing aid should go to a comfort mode or if it should continue to seek audibility. Now, the end user has the ability to override that seek for comfort or audibility within the mobile app. The Eargo SE Rx is a more basic noise management system that will just look to reduce within the different channels. Those are the primary differences between the 7 Rx and the SE Rx. From a charging perspective, battery life is about 16 hours for each of the hearing aids. The charger on the seven will hold a charge for about two to three days. The SE Rx will hold a charge for about three to five days. So the patient can go away for a long weekend and not have to bring a cable along with them. Cool. Okay. So now, the differences in these products versus the OTC products what kind of differences are there among those categories? It’s a great question. And in full transparency, the chip is identical. We didn’t want to create a hearing aid that was completely different because we know that our end patients liked what they were getting. But what we do have is full customability for the patient with our Eargo fit software that’s provided to the hearing professionals. And I’ll share that so you can see in more detail what I’m talking about. So that’s not unlike a lot of other manufacturers. I mean, they, they all have one big chip, and then they defeature it a little here, defeature it a little there, and put things together and kind of make it all work. Exactly right. This is not unusual in that regard at all, from a from a professional standpoint, exactly. What we do know is that when the hearing professional uses the Eargo fit software, they do have the ability to get more usable gain, and because of the programming flexibility. So what we have here is just the actual Eargo fit. Now, we’ve designed our ear go fit. So you don’t have to have cables, you don’t have to have a box. You do need speakers. So if you have a laptop and you have external speakers that are connected to the, the computer, or if you have a wireless Bluetooth speaker, it will work fine. Our software also can be used with a tablet or a smartphone, and it will use the speaker from that. So if you are a hearing care professional who travels and goes out into you know, a nursing facility or something like that, and you don’t want. To have telehealth, you know? Yeah, telehealth. Yeah, absolutely. You don’t have to take everything with you. It’s just easy. So what will happen is, after you’ve selected the product that your patient is wearing, you connect it. The hearing aid will hear a noise that is being generated from the speaker, and it will cause the hearing aid to say one of these seven eight words or sounds. The patient will repeat what they’ve heard. And now the system is connected to the hearing aid to make changes. The hearing professional pops in the audiogram just like we always do. You can point and click, you can drag, whatever the preference is, complete that first fit, just like we’re used to doing, and then the professional, if they need to, can make some adjustments. We have basic adjustments for overall gain, low frequency, high frequency, overall gain. Changes can be made both sides together. If the ear is a little different and you don’t want same kind of changes, you can do an unlinked version for advanced fittings. So if you are doing a real ear measurement or you really want to get in there and adjust based upon your patient complaint or comment, you can do that within the advanced controls. You have access to seven different channels and bands. You can make changes across the board. You can do it this way. You can pick certain frequencies that you want to make the change in as well. So all of those changes once completed, allows you, as the provider, to go ahead and pop in the programs that you would want your patient to have. And let’s go. We’ve done meeting twice. Let’s pick music, load those in, and then you can save the session. And one of the things that I think is really important, as you mentioned, Bob, for telehealth, once you have saved this session and you’re ready, you would copy it. And you can copy this into your NOAH file, into CounselEar, into Sycle.net, whatever session system that you are using in your office, and then you can pull it back up. So if you have multiple locations or multiple audiologists, you go to that patient name, you click on that link, and it will launch back, open but one of the things that I think is really exciting is what’s called the remote restore. So let’s say that you have done a great job with your fitting, but your patient calls you a week or so later and says, you know, I love my hearing aids, but I’d like it to be, you know, just a little bit louder. Well, you may not have the time to get the patient in right away. The patient may have difficulty getting into you. You can go in, make a change, and then generate a remote restore link, which now gives you the ability to copy this link, send it to the patient, to their smartphone. With the click of the restore button, it will asynchronously adjust the hearing aid for the end user. Oh, that’s great. Yeah, so there’s great flexibility and ease with the product. Super. So there are some, some similarities with this remote kind of thing, with actually virtually all the Big 5 that offer that and the movement toward the telehealth area was like a snail’s pace for many years. Then here comes Covid. And of course as we’ve talked, you know, a lot about the COVID area where you practiced, and and now we’re moving a little more toward that. Many clinics are having a certain day when they only do telehealth. Many clinics are now working across state lines and have patients in a lot of places where they can practice due to any licensure, modifications and those kinds of things. And so it’s interesting to see a manufacturer kind of moving toward that area only with almost an emphasis toward a remote thing. It’s almost a bill, it’s almost a combination of your old Internet thing moving forward and moving forward further and then taking it to almost a second quarter, 21st century modification of what we’ve been doing for a long time. Its refreshing to see this movement toward the remoteness. One of the things I see among my students at Rush U and Arkansas and a couple of places where I still teach some practice management courses has to do with the idea that people that the students are seeing a need for people to not have to go to the clinic all the time. They may want to go once in a while, but not all the time. And so their business plans, because I’m doing the practice management stuff there, but their business plans are now talking about mobile units and some sort of way they can refine telehealth and a lot of those issues, which is kind of refreshing to see in the future of our profession as it is refreshing to see in the future of the manufacturers and the way they’re actually moving toward these kinds of things. So yeah, I think the key is optionality, right? I mean, that’s what we find is key to the, and ultimately, what’s all of our goal is to increase the folks that are taking advantage of hearing health, right. And so when you create that optionality, whether it be OTC and prescription or telehealth and face to face and, and all of those different things, it just opens up the options for people to access hearing health. And that’s ultimately what has kept me in this business for 23 years, is continuing to try to increase that penetration pyramid that we always see, right. Especially among the mild to moderate hearing loss. And that’s really where we’re focused. But we know that by providing optionality to patients or potential patients, is ultimately going to increase that adoption. And that’s what we’re all here for. And so we’re excited about this opportunity. I think, you know, it’s not going to be for every practice. We understand that, and that’s totally fine. We know we’ve got, you know, some very large manufacturers that we’re up against, and that’s okay too. Were used to being the underdog and that, and that’s okay. But I think it’s an interesting evolution of our product. Weve got some great internal R&D team that put this together for us. So kudos to them and our clinical team for putting this together. So we’re really excited about it. I think it’s a journey, but I think it’s an interesting one in terms of the evolution of ergo as a brand, for sure. I think one of the interesting things that I know Kim, with your 30 years in the profession, and Bill, with your long term area in the business side of our profession, what I have seen is that there was a time when people, when colleagues like Kim and I actually did some work with manufacturers for a while too. We would have been ostracized by the profession for doing those things and conversing with guys like Bill and others of your positions within the manufacturing area. If you left the clinic side and went to the business side, you were dead meat as far as a professional. And what’s now we’re seeing is not only the business side, but the audiology side, and even the R&D people and engineering. Everybody’s kind of working together to make a better orientation for the hearing impaired. I think that this type of a new device, taking a device has been around for a time modifying it into a kind of a telehealth direct consumer, prescriptive kind of a product. Is an innovation in hearing instrumentation and a progress for the hearing impaired. So today my guests have been Bill Brownie, CEO of Eargo, and Kim White, the audiologist associated with this product and the development of their prescriptive line of instrumentation. And I certainly want to thank you guys for sharing this innovation with us at This Week in Hearing. So thanks again for being with us and we’ll see where all this goes. It’s going to be interesting to watch this as it develops. Thank you very much, Bob. We appreciate the time very much so. And thank you guys, for being with us this week in hearing.