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 hearing aid 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 some ways yes, but for some people it isn’t something that matters.  Private hearing aids will most often offer more advanced technology, such as direct streaming via an iPhone (“Made For Apple”), several intelligent automated features, custom In-The-Ear styles and a multi-functional app, but you might not have any need for all these things.  So, really, 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 closing.  Hearing aid manufacturers are now offering very similar spec in their NHS product as they do in their private product.  That said, most NHS Audiology departments do not offer the more expensive custom-made In-The-Ear or Receiver-In-The-Ear devices.

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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, however much of this is more about convenience than actually hearing better.  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 will not necessarily contribute to hearing better, but will certainly make hearing more convenient.  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.

“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-£60 each for a standard Behind-The-Ear device, whereas private dispensers might purchase a top-spec Receiver-In-The-Ear aid for about £1500-£2000 (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 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 appointment, 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.

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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.  The other main difference between hearing aids from the NHS and privately is the service.  While NHS Audiologists are highly trained and well-educated, they are pressured to see as many people as possible in a very short space of time and appointment waiting lists are usually long.  Even if you don’t have to wait for an appointment for a repair, you still may have the inconvenience of having to wait at a walk-in repair clinic.  Like most other private health care, by seeing a private Audiologist you will most likely never have to wait to be seen and, when you are, you will have much more time with your clinician.

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?  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!

How To Get The Most From Your Hearing Assessment and Hearing Aid Fitting.

How to get the most from your hearing assessment-2Whether you’ve raced straight to your audiologist at the first signs of hearing loss, or you’ve put off the inevitable for decades, your hearing assessment and hearing aid fitting appointments often lay the foundations of your entire hearing aid experience.  The information you provide to your audiologist guides the selection of hearing aid manufacturer, style, model, amplification strategy, programmes, controls, wireless accessory options, etc., so it is important to use your appointment time wisely and provide the concise and highly relevant information your audiologist needs to provide you with a hearing aid that is perfectly tuned to your individual needs.  Read on for a guide on how to get the most from your hearing aid assessment and fitting.

1.  Answer consultation questions with concise and highly relevant answers

Every good audiologist will conduct an initial consultation, which should involve a medical history questionnaire and further questions about your lifestyle and problem listening situations.  The purpose of the medical history questionnaire is to screen for any symptoms that may need onward referral, for example to an ENT specialist, and also to guide further diagnostic tests.  Avoid giving too much detail on less relevant information, such as unrelated or historic illness or other people’s experiences.  Instead, try to answer questions with concise responses that answer the question directly.  This allows your audiologist to cover all the questions they need to ask and get a clear understanding of your hearing needs.

2.  Be honest

Most audiologists want to help people with hearing loss.  While there are of course some hearing aid dispensers who are just out to make money, the vast majority of audiologists have a good understanding of the negative impact hearing loss can have on someone’s life and a strong belief in the potential benefits of today’s hearing technology.  It is not at all uncommon for people with hearing loss to be in denial, and this is very human, but playing down your hearing difficulties or blaming other factors only serves to prolong your struggle and prevent your audiologist from providing help.

3.  Give specific examples of typical difficult listening situations

When it comes to your hearing aid fitting, your audiologist will programme your hearing aids in a way that best compensates for your individual lifestyle and challenging listening situations.  Today’s hearing aid technology is highly advanced and, in most cases, devices can be programmed to work automatically, including volume changes, noise reduction and how the aids focus their microphones forwards in noisy environments.  Think about your lifestyle day-to-day.  Is most conversation 1-2-1 or in groups?  Are you most often in quiet or sometimes in noisy environments?  Do you spend much time outdoors?  Do you listen to music or play a musical instrument?  Do you struggle to hear speech when watching television or talking on the telephone?  Do you particularly struggle to hear speech clearly in background noise?  If you can provide a clear and concise description of your daily lifestyle and difficult listening situations, your audiologist can prescribe your hearing aid fitting more accurately and finely tuned to your individual needs.

4.  Further fine-tuning – try to provide clear descriptions of problems and give specific examples

Most audiologists will invite clients back to the clinic a few weeks later for a follow-up appointment, especially if after an initial trial period.  If you are having a few problems and want some further fine-tuning of the sound or some changes made, try to provide clear descriptions of your experiences.  Your audiologist cannot experience your hearing first-hand, but instead has to make adjustments in the fitting software purely based on your feedback.  Vague comments such as “it sounds a bit strange” or “sometimes I can’t hear” give the audiologist nothing to go on.  Instead, use logical descriptive words such as “traffic is too loud”, “speech sounds very tinny or harsh” or “speech on TV is not clear”.  Specific examples are always helpful, for example, “I went to a restaurant on Saturday and, while using the Restaurant programme, I could not hear conversation clearly because of the background noise of all the other people talking” is more informative than “I can’t hear in noise”.

5.  Embrace modern technology!

Hearing aid technology is advancing at a faster pace than ever before.  While this can be daunting to some, newer technology in hearing aids often makes using a hearing aid easier, not more difficult.  Historically, a hearing aid wearer would face the challenge of having to press a button to change programmes or volume, whereas today, not only are hearing aids much more intelligent and change settings automatically, most manufacturers now offer smartphone apps, which allow end-users to abandon the need to feel around their ear to fiddle with ear-level controls and instead adjust simple-to-see controls on a smartphone or tablet.  Most hearing aid manufacturers also offer other wireless streaming devices to connect to your television and many now offer tele-audiology technology, which allows you to request hearing aid sound adjustments through your app.

We never lose Grandad anymore, now

The key to a successful and productive hearing assessment and hearing aid fitting appointment is good communication.  If you can provide clear, concise and relevant information to your audiologist, he or she will be more equipped to conduct a thorough assessment and provide a finely tuned hearing aid that is personalised to your individual needs.