End of ultrapower hearing aids era?

Some of your assumptions are correct, in that there has been a decline (or major delay) in marketing ultra power aids. But there always been a limited amount of power aids on the market over the last several decades. Oticon Xceed just came out with a new power aid and I believe more HA manufacturers will follow. Reason why - over the counter hearing aids coming in 2020.

The “profit mark up” in HA prices is HUGE but when we start seeing cheaper “over the counter” hearing aids flooding the market, prices will drop, thus profit margins will drop. Competition will bring down prices and reduce profit margins but probably not in “ultra power HA” category. And since there will still be somewhat of a gross profit margin in producing/selling ultra power aids", HA manufactures will probably ramp up “new” offerings next year.

Yea money talks and fools walk and though I hate to say it - I bet people who need hearing aids the most (those in the severe to profound) hearing category will end up paying the most out of pocket - for what ever ultra power aids are offered in 2020 and beyond. So much for Uncle Sam helping the group that needs HA’s the most.

Also over the counter hearing aids are only for customers with mild hearing loss (possible mid-range loss). But if you have a severe to profound loss you out of luck buying anything of substance or quality at your friendly Walmart or Rite AId. So due to pure greed and profit making - I believe in 2020 will we see more new power aids.

1 Like

I’m doubtful about your statements regarding the intent of the OTC HA legislation. You word it as those who need them “the most” and describe that as people with severe loss, but as also stated the devices will actually be for mild to moderate loss. As I understand it the whole point is to make HAs more accessible to millions of older adults with mild hearing loss for whom the current costs are just too high. They might not get quite as good of a result but still be much better off than without and at a fraction of the cost. From my perspective, at least in simple terms that seems like exactly the kind of legislation we should demand from our government. Indeed if anything it is decades too late.

But yes, there are almost always unintended consequences, sometimes positive but often negative. In theory the total market expands significantly and it’s up to the long established manufacturers and dealers to figure out if and how to participate so they can make up in volume what they lose in margin. It’s not entirely different than a name brand drug running out of patents and being challenged by generics. But as you’ve already said there won’t be OTC competition for the high power stuff and many people will still need or want significant personal assistance. I don’t see a big negative impact on the higher power patients but time will tell.

According to the OP though, even the supposedly UHP units still available can’t or won’t deliver in the higher frequencies. I’ve already speculated on that but waiting for someone with confirmation or alternate explanation.

1 Like

As one who has worked with audio devices for decades, my thoughts regarding why the UP and SP HAs are limited in the upper frequencies is more to do with distortion from a single transducer. High power amplification that is faithful to the input signal is a non-issue, but getting a single transducer to faithfully reproduce a very wide frequency band at different power levels is challenging. That’s why you typically see 2-way or 3-way speaker systems.
Just my 2¢.

2 Likes

Well yes, but, you are already narrowing the range by at least several octaves at the bottom
and one at the top, and high frequencies is exactly what tiny transducers are best at. It’s the lows that are inherently challenging from small speakers and typically produces high distortion. But I concede that I don’t know what extremes they have gone through to extract some semblance of bass from a driver smaller than a hifi super-tweeter, so it may compromise the higher frequencies. Still, the claim is that more were available and no longer are. Is the claim incorrect?

BTW, my first programming effort on an Apple II C (color screen!) was to calculate values and draw the schematic for 2, 3 and 4 way passive Butterworth crossovers. So yeah, we probably share some experiences going way back. :slight_smile:

1 Like

I wrote not about high frequencies only, but about overall power output. See my comparison of Oticon Dynamo (my current aids) and Xceed (maybe my next aids?). Oticon Xceed SP and UP fitting range

No Naida UP.

I agree with you. Tiny transducers are best at high frequencies, so don’t know what the problem is there.
I’m sure there some engineering compromise involved here. Perhaps it’s limited to keep current draw within specs. I don’t know. I used to think it was a limit of the DSP, but surely they are using the same DSPs as the lower power models. So, again, it’s curious.

A few years ago, I had some fun designing speaker systems (personal use) using BassBox Pro software to pick a woofer and vent system for a old speaker box I was using. Then used X-over Pro to come up with a matching midrange and tweeter set. Settled on a 2nd-order 3-way with 650/3500 Hz crossover points. It was lots of fun and quite a learning project. Expensive too!

Regarding Ultra Power aids I have yet to see a “full report” pro or con regarding someone’s trial of the Oticon Xceed. The Xceed has been marketed for several months in Europe and probably two months in U.S., yet no one on Hearing Tracker has mentioned that they have tested the hearing aid, much less bought.

So I think it’s very premature for someone to claim the Oticon Xceed to be weaker than another brand of hearing aid. Furthermore if we go a couple more months with (zero) posts one has to wonder it the aid is being trialed at all. So in early 2020 lets see if we can get some feedback on the Oticon Xceed (good or bad) and then compare it to the competition.

Dr. Cliff - Are You Out There?

My post was directed towards lostdeaf’s first post as it relates to lack of current ultra power hearing aids on the market. Regarding OTC HA legislation - any legislation that offers to lower the price of “quality hearing aids” is a move in the right direction. From a "user standpoint’ and “pocket book standpoint”. I have no doubt there are many, many people out there who need hearing aids who can’t afford them. Furthermore there also might be many people who might purchase a hearing aid, if they don’t need to see a doctor first.

But let’s be fair about this upcoming legislation if the FDA ever gets their act together. It’s for people with a minor hearing loss that probably will end up at Walmart, a large Drug store chain or who knows where to purchase their over the counter hearing aid. Will it be a quality HA or something that last 12 months and then fails. Don’t know but if you look at HA history its littered with lousy hearing aids (miracle ear, Beltone, Nano, etc.) that are cheap, display false advertising and more likely have faulty components. Yea that "cheap HA might work while you’re walking out the door but might not last the year out.

Bottom line - those with minor hearing loss will have more options next year to address their medical condition. Hopefully at a lower cost, but buyer beware regarding HA quality and performance.

This is “true” for bass in a room because we don’t like 10-foot speakers in the house. You can’t make a big bass wave with a small paddle. The compromise is very low efficiency (<1%). This is acceptable on wall-power, less so on battery.

But in a HA the “room” is about the size of a pencil eraser. It is much easier to make bass if it is confined. Cars boom good with small amps and speakers, but less-good if the window is open.

In “normal speech/music and normal hearing”, the highs are typically less powerful. This IS because it is hard to shake things as fast as the upper end of the audible range. The output of all acoustic instruments from voice to cymbal falls-off because we can’t blow/hit hard enough to make as much 6kHz as 600Hz.

This is reflected in the many-many “blown tweeters” found in hi-fi repair. While amplifier power is cheap, making a tiny and light moving part means low power capacity.

The drivers used in HAs are HIGH efficiency. But only up to around 3kHz, less if you want HIGH output mid-band. The moving mass will always roll-off the highs. Electronic EQ can flatten the low-level response out to 10kHz, and for moderate loss of highs this can be ample. But 120dB loss in highs implies huge power which would melt a small driver (except they don’t and can’t equip HAs with that much amplifier power).

HA drivers can be “flat” to very low frequency (if well sealed in the ear) but bass output is limited by the microscopic diaphragm motion required for good BA efficiency. That does not concern me but I see how it would limit correction available for some ears.

I sure agree that CI isn’t and can’t be the answer for all.

This case probably needs a VERY determined and well-connected Audiologist who can work with HA companies and also Knowles (who makes many types of HA drivers, not all aimed at HAs), and some careful balancing of performance.

2 Likes

Yes, frequently.

This is an interesting topic because my hearing audiogram is almost exactly like @lostdeaf, and I am currently looking for SP or UP hearing aids. Currently, I am using 7 years old Siemens hearing aids which are really bad. To make matters worse, the mic once failed and got replaced with some copy and after that sound has never been the same. It’s all downhill from there and it’s frustrating.

I am looking at the usual hearing aids which are Naida B and Oticon, however, they both require me to carry an accessory which I don’t want to. I want my hearing aid to directly pair with my iPhone.

I asked Phonak when this tech is coming to their Naida model and they replied, “There is no rough estimate when it will be available. Phonak does not have a date at all when a new Naida will be release. Phonak wants the Naida to have all the features like the Marvel and not just bluetooth connectivity.”

So now I am stuck. Any advice about what I should do? If you look at my audiogram, which SP or UP hearing aids will you recommend which can pair directly with the iPhone?

If you really want direct streaming, go with Resound Enzo 3D.
However, doesn’t new Oticon Xceed allow direct streaming with iPhone? Yes, confirmed Xceed is made for iPhone, as well as Resound Enzo 3D. I think either would be a big improvement over your Siemens.

2 Likes

Thanks @MDB, but none of them are available in my country. I plan to fly to Washington DC for work and will try these hearing aids there. Would you know any audiologists in that city where I can try both Resound Enzo 3D and Oticon Xceed hearing aids? Also, it would be a bonus if they also have Phonak Naida B over there despite it not having Bluetooth connectivity just to compare the sound quality with the other two hearing aids.

Second question, how do audiologists charge in the US? Does taking REM test, configuring different hearing aids for trial, etc cost money? If yes, roughly how much?

Sorry. No clue. I’d suggest using the Hearing Tracker site and look for audiologists in Washington DC (or maybe nearby in Virginia or Maryland) Once you find some likely candidates, give them a call to see what costs would be involved.

1 Like

Behind the Home button in the upper left of each page you can find audiologists in a defined area.

See this post I made in another thread. I think if you want BTE UP aids and MFi to connect wirelessly to an iPhone, your choices are Oticon Xceed, and ReSound ENZO2. If you can get away with a HP receiver your choices are wider and may include a RIC type.

I really want to try Phonak because almost everyone says it’s great for those who have profound hearing loss like me. But I am shocked that none of their hearing aids support MFi tech. Their brand is not listed on Apple’s page: Made for iPhone compatible hearing devices - Apple Support

I am torn if I should get Phonak Naida B right now and then a year or two later try their latest version that will support direct bluetooth connectivity with iPhone. Or should I get Oticon Xceed or Resound Enzo 3D right now and later I can jump to Phonak when they release new SP or UP model with bluetooth connectivity?

Any advice would be welcome and appreciated.

I thought I’d erred in mentioning Resound ENZO3D, but here’s a link. They call it a SuperPower, but it has the 675 battery and fits to 120dB loss.
https://pro.resound.com/en-us/products/hearing-aids/enzo-3d

Perhaps the ENZO3D is a later model than the ENZO2? Don’t know.

I would put the ENZO (whichever one is the later model) ahead of the Naida B. The Xceed is very new. Could it have unexpected issues? Price of course is the other issue.