Question: Why are private hearing aids so expensive?

Q & A 2

When I worked as an Audiologist in the UK’s National Health Service (NHS), I was often asked by my patients questions such as “Are private hearing aids any better than what you get free from the NHS?”, “Might I hear any better with a private hearing aid?”, and “Why are private hearing aids so expensive?”  I always found such questions difficult to answer because I didn’t know for sure if private hearing aids were indeed any better, I didn’t know if the private technology at the time could help a person with hearing loss hear any better and I certainly had no idea as to why NHS hearing aids are free and a pair of private devices can set you back anything up to £6,000.  Of course, I always opted for the “politician’s answer”!

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I was, however, very proud of my NHS – often working in the local hospitals, I witnessed first-hand the enormous amount of hard graft, team-work, tax-payers’ money and impressive amount of training and education that goes into running this mammoth and precious system.  A system that, despite being gargantuan in size, is actually quite fragile and teetering on collapse due to increasing demands and not enough money.  As an NHS Audiologist, I felt proud of the fact we were able to offer good digital hearing aids completely free of charge and always made sure my patients did not assume NHS hearing aids were inferior in quality just because they were free (some UK NHS patients don’t know how lucky they are!).  However, I also advised the patients who asked about private hearing aids to, by all means, see a private Audiologist, but to make sure they trial private hearing aids before they decide to buy and still stand by this advice.

I no longer work in the NHS and now work for a major hearing aid manufacturer that supplies both the public and private sectors.  I now know a lot more about the technology that goes into hearing aids and train both NHS and private Audiologists and Hearing Aid Dispensers on our latest products and software.  I am also now in a better position to answer those tricky questions posed by many an NHS patient all those years ago!

“Are private hearing aids any better than what you get free from the NHS?”

In many ways, yes.  Private hearing aids will most often offer more advanced technology, such as direct audio streaming via an iPhone (“Made For Apple”), several intelligent automated features, custom In-The-Ear styles, rechargeable aids and a multi-functional app.  That said, a private hearing aid with all the associated modern technology is only “better” if you can and will use all the extra options you are buying.  Even just 10 years ago, there was a notable difference between NHS and private hearing aids, but today this gap is beginning to close.  However, NHS Audiology departments do not offer the more expensive custom-made In-The-Ear or Receiver-In-The-Ear devices or accessories unless there is a specific clinical reason to do so, they usually only provide hearing aids from a single manufacturer, and only reassess hearing every three years.

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“Might I hear any better with a private hearing aid?”

As previously mentioned, private hearing aids often come with extra “smart” technology, as they will typically have newer and more advanced computer chips.  Some of this technology is more about convenience, for example, being able to adjust your hearing aids’ volume or noise cancellation via a smartphone app, streaming music directly to your hearing aids via an iPhone or having a tiny custom-made Invisible-In-Canal device.  These features and options will not necessarily directly contribute to hearing better, but will certainly make hearing more convenient.  Other private technology intelligently emulates natural hearing, automatically compensates for varying background noise and can cope better with processing louder sounds and higher frequencies without distortion.

But how well you hear with a hearing aid is as much about its programming as it is about its technology.  The NHS routinely fit hearing aids with a Real-Ear Measurement (REM), an objective test used to fine-tune the sound of the aid to your individual ear canal and verify the aid is amplifying accurately according to your prescription.  REMs are carried out by many private hearing aid dispensers, but not routinely.  It’s always important to remember, how well you hear with any hearing aid is as much about the knowledge, experience and competence of the clinician, as it is about any modern technology.

“Why are private hearing aids so expensive?”

And finally, just why are private hearing aids so incredibly expensive?!  There is one element of better technology costing more.  However, NHS hearing aids usually have a basic cost of about £50-£100 each for a standard device, whereas private Audiologists might purchase a single top-spec aid for anything between £700-£1200 (depending on spec, etc.).  The difference in price at this point is not just about technology, but also about the number of units purchased.  Most NHS Audiology departments in the UK fit hundreds of hearing aids every week and spend hundreds of thousands of pounds on hearing aids each year.  Compare this to an individual private hearing aid dispenser and the number of hearing aid fittings can drop to just one or two per week.  So private dispensers pay a higher cost price for premium hearing aids, so have to charge their customers more, but they also need to charge according to demand and capacity.  A private hearing aid dispenser has far less demand than an NHS department and far less capacity to see many patients.

The other misconception about private hearing aids is that the entire cost customers pay is for the devices alone.  The cost you pay for private hearing aids may also include your consultation, hearing test, ear wax removal, ear impressions, custom-made devices, hearing aid fitting, follow-up appointments, batteries, replacement parts, reassessment, etc.  When you actually cost all of these other included products, services and clinic time, the cost of the actual hearing aids comes down significantly.  Buying a hearing aid is not the same as buying a sofa – you won’t walk out of the store with your new hearing aids and never need to visit again.  Hearing and hearing aids require on-going observation and maintenance.  What you also get by going private is usually no waiting times, longer and more thorough appointments, home visits, and a more personable relationship with the same Audiologist throughout your entire care.

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So, yes, you can get more advanced technology privately and, if you plan to use all of what’s available then it may well be worth the expenditure.  So, if you are weighing up whether to stick with NHS hearing aids or purchase privately, my advice, having worked on both sides, would be to ask yourself: do you want and will you use the latest technology, do you want a very discreet device, do you want to be seen quickly, and would you prefer a slower-paced and more personable service?  If these are all important to you, and of course you can afford it, then private aids may be the right option for you.  However, if your listening needs are not complex (i.e. mostly 1-2-1 conversation in quiet or watching TV), you have no desire for modern technology and don’t mind NHS waiting times and busy clinics, then stick with the fantastic UK NHS!

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