Keywords
hearing aid - over-the-counter - benefit - satisfaction - professional services
In October 2022, regulatory changes in the United States created a category of hearing
aids that allowed them to be sold over-the-counter (OTC), directly to adults with
perceived mid-to-moderate hearing loss.[1]
[2] Before that time, any device labeled as a “hearing aid” could only be purchased
through a professional. The category of hearing aids was created largely in response
to low hearing aid adoption rates,[3]
[4] which were attributed to high cost and limited accessibility.[5]
[6] By allowing consumers to purchase devices directly, OTC hearing aids could be more
accessible than traditional, professionally dispensed hearing aids, and could be potentially
less expensive without the associated professional services. Therefore, OTC hearing
aids should improve the affordability and accessibility of hearing aids, increasing
hearing aid adoption rates among hearing aid candidates.
However, a lingering question is: do consumers benefit from, and are they satisfied
with, their hearing aids if they purchased them “OTC”? Are their satisfaction rates
similar to what would be expected if they had pursued hearing aids through a traditional
model, where a hearing care professional dispensed the hearing aid(s)? Understanding
satisfaction rates is a critical piece in the evaluation of the OTC market. Consumer
satisfaction and willingness to promote their experiences are both important to maintaining
existing consumers and to attracting new buyers.[7] Therefore, the purpose of this study is to review recent data from the MarkeTrak
25 survey exploring satisfaction rates, factors contributing to satisfaction, and
likelihood to recommend hearing aids, for owners of OTC and traditional hearing aids.
Closely related to hearing aid satisfaction is hearing aid benefit, although the constructs
of benefit and satisfaction are different.[8] Whereas satisfaction is the degree to which a consumer has a favorable appraisal
of their experience within the context of their expectations, benefits are related
to improvements in hearing function.[9]
[10] There is reason to expect that hearing aid benefit rates could be different from
satisfaction rates for OTC hearing aids. For example, existing hearing aids available
OTC have been shown to underperform in terms of gain[11]
[12]
[13] and expected sound quality.[14] However, because of their lower price point and potentially lower expectations for
success, consumers might be as satisfied with OTC hearing aids as with higher-cost,
better-fit hearing aids.[15] Therefore, an additional purpose of this study is to review the available evidence
in the MarkeTrak 25 data related to device benefits for OTC and traditional hearing
aids.
Before exploring the differences in hearing aid satisfaction or benefits between OTC
and traditional hearing aids, it is important to examine the market from which the
ratings were obtained. Therefore, summary information about the MarkeTrak 25 survey
respondents and their hearing aids is also presented to contextualize the benefit
and satisfaction findings. These summary details about the respondents and their hearing
aids are also potentially useful for tracking changes in the hearing aid market over
time and for watching the growth of the OTC hearing aid category.
Survey Respondents and Hearing Aids
Survey Respondents and Hearing Aids
The details of the MarkeTrak 25 survey data collection are described elsewhere. [16] In brief, the data reported here are from adults living in the United States with
perceived hearing difficulties who also wear at least one hearing aid (except where
indicated). The hearing aids are either “traditional,” prescription hearing aids in
that they were fit by a hearing care professional (number of respondents with traditional
hearing aids was 1,008). The other type of hearing aid included in this study is OTC
hearing aids, which were obtained directly from a manufacturer outside a traditional
service delivery model (number of respondents with OTC hearing aids was 136).
Survey Respondents
The owners of traditional hearing aids were older (mean age = 70 years) than were
OTC owners (mean age = 52 years). Traditional hearing aid owners were more likely
to be retired (70%) than were OTC hearing aid owners (44%). The owners of traditional
hearing aids also reported a higher annual median income ($77,400) than the OTC hearing
aid owners ($65,500). The owners of traditional and OTC hearing aids had similar gender
ratios, with 56% reporting to be male and 44% reporting to be female. The groups were
also similar to each other in their marital status, with 56% reporting to be married
or having a significant other across both groups. Across both groups of hearing aid
owners (traditional and OTC), 95% of them have cell phones, and 95% of those are smartphones
(approximately evenly divided between Android and iPhone operating systems).
Owners of traditional hearing aids were more likely to have bilateral hearing loss
(84%) than were owners of OTC hearing aids (66%). Among the owners of traditional
hearing aids, 71% had perceived mild-to-moderate hearing loss. Most of the owners
of OTC hearing aids had perceived mild to moderate hearing loss (83%). Although one
might hope 100% of OTC owners had mild-to-moderate hearing loss, it is encouraging
(and expected) that more owners of OTC hearing aids were in that perceived hearing
loss category than were owners of traditional hearing aids.
Hearing Aids
The average age of traditional hearing aids was reported to be 4.7 years, and the
average age for the OTC hearing aids was reported to be 1.5 years. Traditional and
OTC hearing aids were mostly bilaterally fit (83 and 71%, respectively). Consistent
with the age of the devices, only 58% of traditional hearing aid owners were first-time
buyers, whereas 70% of OTC hearing aid owners were first-time buyers. The median cost
per traditional hearing aid was reported to be $1,560, which was significantly higher
than the reported median cost ($150) per OTC hearing aid. Most of the traditional
hearing aids were purchased from an office or a clinic (84%), whereas 31% of OTC hearing
aids were purchased from an office or a clinic. Most of the remaining OTC hearing
aids were purchased from a retailer or pharmacy, either in-store (28%) or online (28%).
Another 11% of OTC hearing aids were purchased from an online-only retailer.
[Fig. 1] shows a breakdown of general hearing aid styles reported by owners of traditional
and OTC hearing aids. The most common hearing aid style reported by owners of traditional
hearing aids was a behind-the-ear style (76%), compared to only 23% of traditional
hearing aids that fit “only inside of the ear.” This percentage of market share of
BTE-style hearing aids is consistent with previous MarkeTrak data; for example, in
2020, 73% of traditional hearing aids were BTEs.[17] Conversely, the market share of BTE devices was much smaller as reported by owners
of OTC hearing aids, where only 42% reported using BTE hearing aids and 57% reported
using in-the-ear style hearing aids. The breakdown of hearing aid styles within the
OTC hearing aids is more consistent with the hearing aid market reported several decades
ago, where BTEs were reported by approximately 47% of hearing aid owners from 2005
to 2008.[18]
Figure 1 Percent of respondents who describe their hearing aids as being behind-the-ear style
or in-the-ear style for each group of hearing aid owners (total, traditional hearing
aids, or over-the-counter hearing aids).
Hearing Aid Features
[Table 1] displays the types of features reported by owners of traditional and OTC hearing
aids. The table demonstrates that owners of OTC hearing aids were more likely to report
having standard features (e.g., volume controls, rechargeable hearing aids or batteries,
telecoils, and tinnitus maskers) than were owners of traditional hearing aids. However,
owners of traditional hearing aids were more likely to report having wireless capabilities
(e.g., streaming from a smartphone directly) than were owners of OTC devices. Owners
of OTC hearing aids were are more likely than owners of traditional hearing aids to
report using accessories, like television streams or companion microphones. Among
owners of traditional hearing aids, use of television streamers and companion microphones
has declined from 27 and 25%, respectively, in 2022. These data suggest the use of
these accessories is declining among owners of traditional hearing aids, but not among
owners of OTC hearing aids. On the increase, however, are wireless capabilities, which
are reported by more than 70% of traditional hearing aid owners, up from 43% as recently
as 2015.[19]
Table 1
Hearing aid features and capabilities reported by owners of traditional and OTC hearing
aids
|
|
Traditional (n = 742)
|
OTC (n = 127)
|
|
Features
|
Volume control
|
73%
|
84%[a]
|
|
Program button
|
54%
|
45%
|
|
Rechargeable hearing aid
|
67%
|
80%[a]
|
|
Directional, dual, twin, or multiple microphones
|
30%
|
31%
|
|
Rechargeable batteries
|
17%
|
35%[a]
|
|
Telecoil
|
23%
|
34%[a]
|
|
Tinnitus masker
|
15%
|
28%[a]
|
|
Wireless capabilities
|
The ability to “link” volume or program changes
|
52%
|
50%
|
|
The ability to stream sound from a smartphone directly
|
58%[a]
|
40%
|
|
The ability to stream sound using an additional accessory
|
33%
|
39%
|
|
NET: wireless hearing aid (calculated)
|
72%[a]
|
60%
|
|
Accessories/apps
|
Downloadable “app” for smartphones
|
55%
|
46%
|
|
Hearing aid remote control
|
35%
|
37%
|
|
Body-worn Bluetooth device
|
24%
|
31%
|
|
TV streamer
|
16%
|
29%[a]
|
|
Companion microphone
|
13%
|
27%[a]
|
Note: The specific question respondents answered was, “Below are some different hearing
aid features, capabilities, or accessories/apps. Please indicate whether your current
hearing aid has each one, as far as you know.” Data are displayed only for respondents
who purchased hearing aids within the last 5 years.
a Indicates significant differences between traditional and OTC at the 90% confidence
level; differences are also in bold typeface.
Hearing Aid Benefits
Listening Situations
The hearing aid owners represented in the MarkeTrak 25 survey data were generally
satisfied with their ability to hear in many listening situations, especially compared
to nonowners. The nonowners are adults who report similar difficulty hearing but have
not adopted hearing aids (see participant sample description in Dobyan and Kihm, 2025).[16] Overall, 43% of nonowners were satisfied with their ability to hear across all listening
situations, whereas 79% of traditional and 76% of OTC hearing aid owners reported
feeling satisfied with their ability to hear across all listening situations. The
difference in hearing abilities between owners of traditional and OTC hearing aids
was not statistically significant.
Although the difference in hearing ability between owners and nonowners in a variety
of situations is not a traditional measure of benefit (classically defined as the
difference between performance with and without a hearing aid for the same person),
the cross-group comparison in hearing ability could be broadly interpreted as hearing
aid benefit. That is, it could be assumed that, without their hearing aids, the hearing
aid owners would be less likely to be satisfied with their ability to hear in those
listening situations than they are with their hearing aids.
[Fig. 2] further explores the types of listening situations where nonowners, owners of traditional
hearing aids, and owners of OTC hearing aids report being satisfied with their ability
to hear. In this figure, the situations are rank-ordered by difficulty as reported
by adults who do not own hearing aids. This figure demonstrates that the fewest nonowners
reported satisfaction with their ability to hear when trying to follow conversations
in noise, whereas most respondents, even without hearing aids, were satisfied with
their ability to listen to music and to converse with one other person. Also evident
in this figure are the situations where hearing aids were the most beneficial (e.g.,
those at the top of the figure, including in background noise and in large groups),
but also the small, statistically nonsignificant differences between perceived listening
abilities for adults with traditional and OTC hearing aids. That is, from the perspective
of the hearing aid owners, OTC hearing aids can be beneficial across a wide variety
of listening situations, similar to traditional hearing aids.
Figure 2 Percent of respondents who report being satisfied with their ability to hear in each
listening situation. Groups displayed include adults with hearing difficulty who do
not wear hearing aids (nonowners; blue), who own OTC hearing aids (purple), and who
own traditional hearing aids (green).
The robust benefits that are similar between traditional and OTC hearing aids are
consistent with some existing studies in the literature, showing similar benefits
of OTC and traditional hearing aids.[20]
[21]
[22]
[23]
[24] However, the current findings are inconsistent with some studies, which show larger
benefits with traditional than OTC hearing aids.[25]
[26] Although there are a number of methodological differences between these studies
(e.g., outcome measures, random assignment, etc.), perhaps the most important difference
of note is that the estimated hearing aid benefits in the current study are largely
driven by the perceived difficulty of the nonowner group. That is, the hearing aids
appear to be the most beneficial in noisy situations in the current study, not because
owners are most likely to be satisfied in those situations, but because nonowners
are least likely to be satisfied in those situations.
SATISFACTION RATES
The MarkeTrak 25 survey included satisfaction questions, all of which have the same
response structure; respondents indicate how satisfied or dissatisfied they are on
a scale of 1 to 7, with 1 indicating very dissatisfied and 7 indicating very satisfied.
Often in the analysis of the data, scores of 1 to 3 are grouped together and described
as “bottom-3 box” scores, capturing the respondents who indicate any degree of dissatisfaction.
Similarly, people who indicate a score of 5 to 7 are grouped together to indicate
“top-3 box” scores, indicating any degree of satisfaction. Scores of 4 are interpreted
as neutral.
Hearing Aid Satisfaction
As displayed in [Fig. 3], hearing aid satisfaction rates are high overall; 82% of all hearing aid owners
report being satisfied with their hearing aid(s). The satisfaction rates with traditional
hearing aids have remained stable over the last 10 years, ranging between only 81and
83%.[19] Overall satisfaction rates were only a few points different when traditional and
OTC hearing aids were considered separately (83 and 76% of respondents were satisfied,
respectively).
Figure 3 Percent of respondents who provided each satisfaction rating overall and for owners
of OTC and traditional hearing aids, separately. Also displayed are the overall satisfaction
rates for the top-3 box scores overall and for each group.
However, owners of those two hearing aid types varied in how satisfied they were with
aspects of hearing aids. As displayed in [Table 2], owners of traditional hearing aids were more satisfied than their OTC counterparts
in terms of reliability and size of hearing aids. Owners of OTC hearing aids were
more satisfied with the price of their hearing aids than were owners of traditional
hearing aids. Both groups of owners were similarly satisfied with the value of the
device.
Table 2
Percent of owners of traditional and OTC hearing aids that are satisfied (top-3 box
ratings) or dissatisfied (bottom-3 box ratings) with aspects of their hearing aids
|
Aspect
|
% Satisfied (top-3 box)
|
% Dissatisfied (bottom-3 box)
|
|
Traditional (n = 742)
|
OTC (n = 127)
|
Traditional (n = 742)
|
OTC (n = 127)
|
|
Physical
|
Reliability
|
86%[a]
|
77%
|
5%
|
10%[a]
|
|
Size
|
84%[a]
|
74%
|
6%
|
8%
|
|
Physical comfort
|
81%
|
76%
|
7%
|
13%
|
|
Appearance
|
81%
|
79%
|
3%
|
8%[
a
]
|
|
Visibility to others
|
79%
|
79%
|
5%
|
10%[a]
|
|
Sound
|
Clarity of tone and sound
|
79%
|
77%
|
9%
|
10%
|
|
Degree it manages whistling/feedback
|
79%
|
70%
|
8%
|
12%
|
|
How natural things sound
|
79%
|
71%
|
8%
|
9%
|
|
Richness or fidelity of sound
|
78%
|
75%
|
7%
|
9%
|
|
Ability to tell the direction of sound
|
78%
|
74%
|
8%
|
14%[a]
|
|
Comfort when listening to loud sounds
|
74%
|
76%
|
11%
|
7%
|
|
Ability to minimize background noise
|
67%
|
69%
|
14%
|
16%
|
|
Usage
|
Ease of charging the battery
|
87%
|
83%
|
3%
|
6%
|
|
Ease of use
|
86%
|
81%
|
5%
|
5%
|
|
Battery life
|
80%
|
76%
|
7%
|
9%
|
|
Ease of cleaning/care
|
79%
|
77%
|
5%
|
8%
|
|
Ease of changing the battery
|
78%
|
76%
|
6%
|
7%
|
|
Price/value
|
Overall value
|
83%
|
80%
|
6%
|
7%
|
|
Out-of-pocket price paid
|
69%
|
85%[a]
|
15%[a]
|
4%
|
Note: Owners are those who got their hearing aids within the last 5 years.
a Indicates significant differences between traditional and OTC hearing aids at the
95% confidence level; differences are also in bold typeface.
Demographic Factors Related to Satisfaction
[Table 3] displays differences between owners of traditional and OTC hearing aids who were
(top-3 box) and were not satisfied (combined neutral and bottom-3 box). Evident in
this table are factors that contribute to satisfaction. Specifically, among owners
of OTC hearing aids, males were more likely to be satisfied with their hearing aids
than were females. Also, among owners of OTC hearing aids, college graduates were
more likely to be satisfied with traditional hearing aids than with OTC hearing aids.
For both groups (owners of traditional and OTC hearing aids), those with higher annual
household incomes were more likely to be satisfied with their hearing aids. Although
owners of OTC hearing aids were younger than owners of traditional hearing aids, age
did not seem to affect device satisfaction within either group.
Table 3
Demographic differences between satisfied and neutral/not satisfied owners of traditional
and over-the-counter hearing aids
|
|
Traditional hearing aid owners
|
OTC hearing aid owners
|
|
Satisfied (top-3 box; n = 830)
|
Neutral/not satisfied (n = 172)
|
Satisfied (top-3 box; n = 103)
|
Neutral/not satisfied (n = 33)[b]
|
|
Age
|
Average age
|
70
|
69
|
53
|
51
|
|
% Less than 35
|
6%
|
6%
|
26%
|
38%
|
|
% 35–64
|
20%
|
24%
|
31%
|
15%
|
|
% 65+
|
74%
|
70%
|
43%
|
47%
|
|
Gender
|
% Male
|
57%
|
54%
|
63%[a]
|
35%
|
|
% Female
|
43%
|
46%
|
37%
|
65%[a]
|
|
Education and income
|
% College degree
|
49%
|
42%
|
43%[a]
|
17%
|
|
Average income
|
$95,700[a]
|
$76,600
|
$88,200[a]
|
$53,700
|
a Indicates significant differences between percentages of satisfied and not satisfied
respondents at the 95% confidence level; differences are also in bold typeface.
b Relatively small sample size.
Device Factors Related to Satisfaction
[Table 4] displays differences between satisfied and unsatisfied owners on some hearing aid
device factors. Interestingly, the only driver of satisfaction specific to the device
was price; even then, it was only evident among owners of OTC hearing aids. Specifically,
owners of OTC hearing aids who were satisfied paid more for their devices (median:
$584) than did owners who were not satisfied (median: $272). The role of hearing aid
cost for satisfaction rates is consistent with the finding that higher cost OTC hearing
aids have better design aesthetics and electroacoustic properties.[13] Within the owners of traditional hearing aids, price did not meaningfully contribute
to ratings of satisfaction; in fact, the trend was in the other direction, where satisfied
owners of traditional hearing aids paid less (median: $1,690) than did nonsatisfied
owners (median: $1,800).
Table 4
Device and service-delivery differences between satisfied and neutral/not satisfied
owners of traditional and over-the-counter hearing aids
|
|
Traditional hearing aid owners
|
OTC hearing aid owners
|
|
Satisfied (top-3 box)
|
Neutral/not satisfied
|
Satisfied (top-3 box)
|
Neutral/not satisfied
|
|
Age of hearing aid
|
|
(n = 794)
|
(n = 161)
|
(n = 99)[b]
|
(n = 33)[b]
|
|
Average age of the most recent hearing aid
|
4 y
|
4 y
|
2 y
|
1 y
|
|
Price of a hearing aid
|
|
(n = 438)
|
(n = 65)
|
(n = 62)[b]
|
(n = 18)[b]
|
|
Average price
|
$1,690
|
$1,800
|
$584[a]
|
$272
|
|
Purchase place
|
|
(n = 830)
|
(n = 172)
|
(n = 103)
|
(n = 33)[b]
|
|
Office, clinic, or center
|
81%
|
87%
|
24%
|
36%
|
|
Retailer or pharmacy—in-store
|
17%
|
9%
|
29%
|
15%
|
|
Retailer, pharmacy, or HA brand's website
|
1%
|
1%
|
32%
|
36%
|
|
Online-only retailer (e.g., Amazon)
|
0%
|
0%
|
14%
|
9%
|
|
Somewhere else
|
1%
|
2%
|
1%
|
3%
|
Note: Price is reported for only those respondents who could recall the price paid.
a Indicates significant differences between satisfied and not satisfied respondents
at the 90% confidence level; differences are also in bold typeface.
b Relatively small sample size.
Importance of Professional Services
Finally, accessing professional services was related to device satisfaction. As shown
in [Fig. 4], those who received some hearing care professional assistance were more satisfied
than those who did not receive any professional services. Because almost 100% of owners
of traditional hearing aids received professional services, this difference in satisfaction
between those who did and did not receive professional services is largely due to
the OTC hearing aid category. Among owners of OTC hearing aids, only one in five did
not receive any kind of professional services; 72% of OTC owners received a professional
evaluation, 59% received help selecting a device, and 56% received help getting fitted
initially. This combination of findings highlights both the prevalence and importance
of hearing care professionals in the dispensing and support of hearing aids, even
in an OTC service-delivery model. This finding adds to a growing body of literature
demonstrating that professional services are important for success for some people,
even with devices that are designed to be delivered directly to consumers.[27]
Figure 4 Percent of respondents who provided each satisfaction rating based on whether or
not they received professional services (specifically an evaluation, selection, or
fitting).
Recommendations to Others
Most hearing aid owners (83%) would recommend a hearing aid to a friend or family
member. However, the percentage is higher for owners of traditional hearing aids (85%)
than for owners of OTC hearing aids (73%). Consistent with this finding, net promoter
scores (NPS) were higher for owners of traditional than OTC hearing aids. An NPS indicates
loyalty based on the likelihood of recommendations.[28] In this case, respondents rated how likely they were to recommend the establishment
from which they bought their hearing aid(s). The likelihood scores range from 0 to
10, with scores 0 to 6 indicating a respondent is a “detractor,” scores of 7 or 8
indicating a respondent is a “passive,” and scores of 9 or 10 indicating a respondent
is a “promoter.” The NPS is the calculated difference between the percent of respondents
who were “promoters” and “detractors.” A positive NPS indicates an establishment is
likely to be recommended, whereas a score near 0 indicates neutrality (an establishment
is neither likely nor unlikely to be recommended). Although the relationships are
imperfect, the NPS has been related to brand growth[29]
[30] and customer loyalty.[31] Therefore, NPSs not only provide insights into device satisfaction, but they could
also be informative for predicting future trends of market growth or customer maintenance.
In the MarkeTrak 25 data, the NPS overall for hearing aid owners was quite positive,
at +25, suggesting more people were likely to recommend than detract the establishment
from where they purchased their hearing aids (see [Fig. 5]). However, there was an important difference in NPS between owners of traditional
and OTC hearing aids, with the former being quite positive (+30) and the latter being
neutral (0). These data are remarkably similar to the data from MarkeTrak 2022, where
the NPS for the traditional hearing aids was 30.4 and the NPSs for remote- and self-fit
hearing aids (categories comparable to the OTC category in 2025) were −4 and +3, respectively.[19]
Figure 5 Net promoter scores overall and for each type of hearing aid (OTC or traditional).
Displayed are the percentages of respondents who are detractors, neutral, and promoters,
in addition to the overall net promoter score.
The difference between owners of traditional and OTC hearing aids was driven not by
passives, but by detractors (as seen in [Fig. 5]). Nearly 40% of owners of OTC hearing aids were detractors, and thus unlikely to
recommend that a friend follow a similar path to theirs in getting an OTC hearing
aid. This suggests that the OTC hearing aids are not inspiring market growth because
they are not likely to be recommended overall and, in some cases, are likely to be
recommended against. If the NPSs do not improve for OTC hearing aid brands, the OTC
hearing aid market might not grow. As the market continues to evolve, it will be important
to continue to monitor the NPSs.
Future Directions
There are a couple of important factors to consider in terms of the generalizability
of these findings, all of which are directions for future exploration. First, the
MarkeTrak survey results are inherently cross-sectional, providing information at
the group level. Although some evidence suggests similarity in outcomes between traditional
and self-fit devices using designs that are between-groups[20]
[21]
[24] or within-participant,[22]
[23] the degree to which a traditional or OTC hearing aid is appropriate for a given
individual is not addressed with these data because respondents self-selected their
devices.
The MarkeTrak 25 data provide insights into the self-selection bias (e.g., owners
of OTC hearing aids are younger, with less hearing difficulty than owners of traditional
hearing aids). There are some hints in the current data that some owners of OTC hearing
aids could benefit instead from traditional hearing aids, or at least from having
more support from hearing care professionals. For example, although 66% of OTC hearing
aid owners reported having bilateral hearing loss, 71% of them reported having bilateral
hearing aids. This suggests that the hearing aids are not well-matched to some owners'
hearing ability. Furthermore, more than half of owners of OTC hearing aids reported
that they thought a hearing care professional could have helped either a great deal
(30%) or moderately (29%), suggesting they pursued a direct-to-consumer model, but
would have benefited from having professional services. Future work is warranted to
explore whether the self-selection into a particular device category is largely appropriate
for most consumers or if a subset of consumers would actually be more satisfied or
benefit more from the alternative device type.
Related, the comparison between OTC and traditional hearing aids is somewhat complicated
by the degree of hearing difficulty, which is largely not addressed in this data set.
Owners of traditional hearing aids were more likely to have bilateral hearing loss
and were less likely to have “mild-to-moderate” hearing loss than were owners of OTC
hearing aids. Because OTC hearing aids were designed specifically for adults with
perceived mild-to-moderate hearing loss, one would expect benefit and satisfaction
ratings for OTC and traditional hearing aids to diverge if the adults in the OTC category
had more significant hearing losses. That is, the conclusion that traditional and
OTC hearing aids are similarly beneficial and satisfactory primarily applies to the
population of people for whom OTC hearing aids are appropriate. The current data do
not offer insights into the expansion of the OTC candidacy to adults with more than
a perceived mild to moderate hearing loss.
Finally, it is not clear which devices, or even which type of OTC devices, are represented
in the data. There are a multitude of ways to obtain OTC hearing aids[32] and there is variability in the OTC hearing aid market,[33] which means that the services, usability, and devices vary considerably. The variability
means the OTC hearing aids described in the current data set could be reasonably expected
to represent a wide range of electroacoustic capabilities and expected sound quality.[13]
[14] For example, one important distinction within the existing literature is the difference
between OTC hearing aids whose gain configurations are preset or are the result of
self-fitting, user interactions. Using self-fit hearing aids, in comparison to professionally-fit,
several studies have shown similarity in outcomes.[20]
[21]
[22]
[23]
[24] Conversely, using OTC hearing aids with presets, instead of self-fitting functionality,
studies have demonstrated the inferiority of OTC hearing aids on some outcome measures.[25]
[26] Future work is warranted to disentangle the type of device from the service model
in terms of hearing aid benefit and satisfaction.
Conclusion
Results of the MarkeTrak 25 survey demonstrate robust benefits and high satisfaction
rates for both OTC and traditional hearing aids. However, there are some differences
in trends between OTC and traditional hearing aids. Specifically, within traditional
hearing aids, there is remarkable stability in terms of benefits, satisfaction rates
(83% of hearing aid owners are satisfied), and NPS (+30 points for promoters relative
to detractors) compared to previous years [16, 18]. These values are essentially unchanged
over the last several years, suggesting the introduction of the formal OTC hearing
aid category has not affected the benefit or satisfaction of traditional hearing aids.
The OTC hearing aids themselves have similar benefits as traditional hearing aids,
although slightly lower satisfaction rates (76% of OTC hearing aid owners are satisfied).
Compared to owners of traditional hearing aids, owners of OTC hearing aids were less
likely to be satisfied with the size and reliability of their hearing aids, although
they were more likely to be satisfied with the price of the hearing aids. The current
data also highlight the importance of professional services, even within the group
of OTC hearing aid owners. Not only did most OTC hearing aid owners (approximately
80%) utilize some type of professional service, but those who did receive professional
support were more likely to be satisfied with their hearing aids than were those who
did not receive professional services. Therefore, although the OTC hearing aids are
beneficial and consumers are satisfied with them, professional support continues to
be an important and beneficial aspect in the OTC category of hearing aids.