It has been five years since Congress ordered federal regulators to develop regulations that will allow for hearing aids to be sold over the counter. Yet people today still can’t purchase them.
A bipartisan group of senators wants to change that. In April, a quartet led by Chuck Grassley, R-Iowa, and Elizabeth Warren, D-Mass., introduced legislation that would compel the Food and Drug Administration to finalize its rules on OTC hearing aids within 30 days.
It’s long past time for the agency to get its act together. Millions of Americans would benefit from improved access to hearing aids. Permitting their sale over the counter would inject some dynamism into a market that needs it — and lead to lower prices.
Thirteen percent of American adults — 38 million people — suffer from hearing loss. Hearing aids could dramatically improve their ability to communicate and live productive and satisfying lives. Yet, just one-fifth of Americans who would benefit from such devices use them.
Only about one in 20 people in their 50s with hearing loss uses a hearing aid.
That’s often because hearing aids are expensive. At present, they seldom cost less than $1,000. They can sometimes go for more than $6,000.
People can’t get much help with those costs. Hearing aids aren’t covered by Medicare or many private health plans.
And since hearing aids require a prescription, patients who need them must also deal with the cost and inconvenience of visiting an audiologist — care that may not be covered by insurance.
Allowing the devices to be sold over the counter could expand access and lower their cost.
People are far more likely to seek hearing aids if they can pick them up without an intermediary, as with other essential medical treatments and technologies.
A bigger potential market will attract more manufacturers offering more products. That competition will put downward pressure on prices — and lead to the availability of a wider variety of hearing aids that address different segments of the market.
The upshot will be more widespread adoption of hearing aids and lower overall costs.
This line of thinking inspired senators Grassley and Warren, among others, to sponsor the Over-the-Counter Hearing Aid Act back in 2017. The FDA was supposed to finalize regulations that would have implemented the law in 2020. The agency missed that deadline by more than a year. Public comments on the proposed rule didn’t close until January of this year.
Hence, the new round of legislation from Grassley and Warren.
Opponents of OTC hearing aids — like audiologists and others who benefit from the current system — point out that hearing loss can signal a bigger problem. If people don’t have to visit a healthcare provider to get hearing aids, the thinking goes, that these health concerns could go undiagnosed.
Many audiologists also argue that getting hearing aids over the counter without a prescriptive fitting will undermine their effectiveness — and cause people to conclude that hearing aids won’t work for them.
Healthcare providers have long made arguments like these to try to control the supply of medical care — and keep its price high. Optometrists still grouse about letting consumers order contact lenses online. Doctor organizations lobby state legislators all over the country to restrict the ability of nurse practitioners and physician assistants to treat patients independently.
Barriers like these may benefit incumbent providers. But they raise costs for patients and the rest of the healthcare system.
Further, people will still have the option of seeking the professional assistance of an audiologist. They just won’t be required to do so.
Consumers today buy even more advanced technology than the latest hearing aids without professional assistance. It’s infantilizing to believe they won’t be able to handle shopping for the devices on their own.
Selling hearing aids over the counter will make them more accessible to millions of people. Consumers have waited five years for improved access. They shouldn’t have to wait any longer.
