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DOI: 10.1055/s-0045-1812042
MarkeTrak 2025: Consumer Perspectives on Hearing Health in an Evolving Market
Authors
Abstract
MarkeTrak has been monitoring trends within the hearing industry for nearly 40 years. The latest edition, MarkeTrak 25, examines adoption rates, satisfaction with devices and professionals, coverage for hearing aids, and more. In this survey, OTC hearing aids were added to the device list to understand how they fit into the market and whether OTC buyers are using professional assistance, even though it is not required by the FDA for purchase. Key findings indicate that the overall adoption rate for all hearing devices (including earbuds with hearing improvement features) has increased to over half, satisfaction levels with devices and professionals have remained stable and very high, and financial assistance has increased since the last survey.
The MarkeTrak survey is conducted every few years and strives to include questions about the range of products, services, and channel options available at the time of each wave of the study, while still maintaining core questions that track satisfaction, costs, and consumer preferences. In 2022, when the results from the previous wave of MarkeTrak were released, the regulatory changes allowing for the sale of over-the-counter (OTC) hearing aids were just being published and the COVID-19 pandemic was disrupting the way consumers accessed products and services including hearing aids. In the last few years, the hearing aid industry has experienced important developments driven by more OTC options (e.g., a new category of OTC hearing aids and consumer products incorporating medical device software into earbuds and eyeglasses). To reflect the regulatory changes and the full range of products and services available for hearing healthcare, MarkeTrak 2025 included new definitions for hearing aids to differentiate OTC from prescription options and an updated definition for earbuds containing hearing improvement features.
Methodology
Beginning in 1989, the early versions of MarkeTrak were fielded using a two-step mail survey sent to a national research panel. In 2015, the MarkeTrak survey was converted to an online format after a feasibility analysis confirmed the online research capabilities and processes were mature enough to handle a study of this size and complexity. The core components of the initial MarkeTrak mail surveys were integrated into a more nimble and robust design developed and administered by AZ Marketing Research. MarkeTrak 2025 (MT25) is the fourth online wave and was fielded in October and November of 2024, with a sample size of 16,148 households capturing data on 42,982 individuals. This representative, national sample was used to estimate key conditions and adoption rates within the industry. A sub-sample of 2,955 individuals with self-reported hearing difficulty continued on to answer additional questions about their hearing loss journey. Questions were catered to each individual based upon the steps taken by the individual and devices tried to date. This sample was comprised of 1,173 hearing aid owners and 1,782 non-owners.
Results
Self-reported Hearing Difficulty
The first finding of note is a decrease in the rate of self-reported hearing difficulty. The rate had been stable at around 10 to 11% in all previous MarkeTrak waves, while the initial analysis of the MT25 data reflected a dip in this rate. To explore this finding further, additional sample was added and analyzed, resulting in a final self-reported hearing difficulty rate of 9.1%, as shown in [Fig. 1]. Several factors were considered that may have contributed to the decline, including the timing of the survey (just prior to and during the 2024 election).
Adoption Rates
The adoption rate for all hearing aids combined among those with self-reported hearing difficulty increased from 3 in 10 (30.2%) in 2015 to almost 4 in 10 (39.1%) in 2025. The rate was similar, although slightly lower in an absolute sense, in 2022 (at 38.4%). A comprehensive view of adoption rates for all devices, including prescription and OTC hearing aids, implants, and earbuds is shown in [Fig. 2]. With all devices considered, the total adoption rate climbed to over half (at 51.3%), up from 46.9% in 2022. This is the result of incremental changes for each of the devices tracked in the past (including implants) and the contribution from the OTC hearing aid category. The adoption rates for each device are shown in [Fig. 3]. For those with self-reported loss, the OTC category accounts for approximately 6% and contributes an incremental 4% to the overall adoption rate. This OTC category attracts a unique section of customers who are younger on average.
Purchase Pathways
Another area of interest is the difference in buying patterns between OTC hearing aid purchasers and prescription hearing aid purchasers. [Fig. 4] illustrates where devices were purchased and demonstrates that prescription hearing aid owners purchase most often from a clinic or hearing center (84%) while the majority of OTC hearing aid owners (67%) purchase completely online or from a retailer or pharmacy (either online or in person). However, a segment of OTC buyers did report purchasing their OTC hearing aid from a clinic or hearing center (31%). Even though no professional assistance is required for OTC hearing aids, many OTC owners report having received some guidance or assistance along the way.
Consumer Priorities
An interesting dichotomy emerged when examining the listening environments most important to users of each hearing aid category (prescription and OTC). Both user groups feel it is most important to hear well during conversations (in noisy environments, at home, in small groups, etc.). However, as shown in [Fig. 5], a substantially higher proportion of prescription hearing aid users than OTC hearing aid users feel hearing well in those environments is important. Conversely, a substantially higher proportion of OTC hearing aid users than prescription hearing aid users feel it is important to hear well in a range of other environments (such as shopping, outdoors, and leisure activities).
Brand Awareness
In MarkeTrak 2022, only about 30% of hearing aid owners reported knowing their brand of hearing aid. The data from MT25 indicate increased brand awareness, with 47% being able to recall the brand. This rate is more aligned with brand awareness levels reported in the 2015 and 2019 MarkeTrak waves (which were both in the mid-40%).
The hearing aid brand appears to play a larger role for those buying OTC hearing aids than for those buying prescription hearing aids. As shown in [Fig. 6], when participants were asked about purchase factors, about twice as many OTC hearing aid owners than prescription hearing aid owners reported having a brand in mind prior to purchase. OTC owners also purchased the brand they had in mind at higher levels than prescription owners (16% vs. 8%); however, their overall brand awareness is not higher. When asked about the purchase, prescription hearing aid users who ended up with a different brand than they had in mind reported that during the discussion with the hearing care professional another brand was presented, or the brand they had in mind was not available at that location. In addition to an increase in brand awareness, more owners today report having hearing aids with wireless capability, rechargeability, and volume control, all of which contribute positively to the user experience.
Quality of Life
One important goal in addressing and treating hearing difficulty is to improve quality of life. Many factors influence overall satisfaction with the hearing aid and perceptions of how it contributes to improved quality of life, including better communication, more personal confidence, and better work performance (among those respondents still working). Across all hearing aid owners, the top two contributors to improved quality of life are improvements in self-confidence and an increased ability to communicate effectively, as shown in [Fig. 7]. An impressive 90% of all hearing aid owners report that their devices improve quality of life regularly or occasionally. Satisfaction with the hearing aids themselves remains high, with 83% of all owners being satisfied, and those who receive professional support expressing higher rates of satisfaction than those who do not.
Coverage
More hearing aid owners reported having coverage for their hearing aids than in the past (63% in 2025 vs. 54% in 2022). MT25 finds the top sources of coverage to be Medicare Advantage, followed by insurance or health maintenance organizations (HMO), and then military or Department of Veterans Affairs (VA). Among those with coverage, 24% reported having full coverage with no co-pay or deductible. When it comes to non-owners, cost and a lack of coverage continue to be significant barriers that stop many from taking the next step toward a solution. This is especially true for non-owners who have received a recommendation from a professional to get hearing aids but have not yet done so.
Conclusion
At the end of the survey, participants were given the opportunity to provide open-ended comments about their participation. [Fig. 8] highlights several of these. Of particular note is a comment from a hearing aid owner that identifies hearing loss as an important issue that should have more public awareness, and a comment from a non-owner that highlights an awareness gap and how this survey made them think more seriously about aids.
The MarkeTrak surveys provide valuable insights into consumer behaviors and motivations that can help shape hearing health awareness and education efforts. This introductory article provides background on the methodology and highlights key trends and updates from the most recent wave. Key takeaways from the overall study include:
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Demographics: New purchase pathways have shifted and, in some cases, expanded the profile of hearing aid owners.
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Devices: Adoption rates continue to increase, but different perceptions and motivations exist depending on the user and purchase pathway (and showcase some lingering consumer confusion following regulatory changes).
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Delivery: MT25 explores the importance of the role of the professional across segments with varying levels of support and engagement.
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Drivers: The hearing health landscape continues to shift, with MT25 highlighting additional consumer insights into the importance of hearing health and reasons for either moving forward or stalling on their journey.
Not all key takeaways are discussed in this introductory article. Other articles that follow in this journal will provide more detail on specific topics.
Conflict of Interest
None declared.
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Publication History
Article published online:
03 October 2025
© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
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