Some comments from a Systems Engineer at a Hearing Aid company

Systems Engineer at Hearing Aid Company AMA

https://www.reddit.com/r/HearingAids/comments/11vrau0/systems_engineer_at_hearing_aid_company_ama/

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Keynotes for me:

  • “Do you talk with people who wear HAs / read about our experiences to figure out features/programming, or are your tasks market driven?”

The Product Management group does market research and they work with patients. Generally everyone in that group are audiologists have many years of experience working with patients. Personally I get excited if I see people in public wearing hearing aids no matter if it is my company’s. Since there is a big stigma in for patient’s, I hesitate to mention it but I’d love to talk to patients.

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  • Do you think HAs will ever include amplification for frequencies greater than 8 kHz?

Short answer, no. I was surprised by this myself because before I started this job, I knew that most humans can hear up to ~20kHz. I learned that even if we greatly amplify the channels between 10kHz-12kHz, most people with hearing loss would never hear it anyways. The main use case we are concerned about is interpreting speech and all those frequencies are below 4kHz so anything above 10kHz doesn’t add a great amount of value anyways. Even further, it becomes increasingly harder for the hardware and firmware to obtain and process those higher frequencies. If it was demanded by the market, all the fitting formulas we’ve used for years would need to be revisited too. There is very little demand, little payoff, and would drive the price up greatly because of the difficulty.

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  • How waterproof is “water resistant” really? My audiologist said they can honestly be fished out of a pool and be fine, but sort of like iPhones can’t be advertised as waterproof for liability reasons.

I would not trust any hearing aids to go underwater. It may be certified to do so but it’s not a good idea. Some of them, you should absolutely not bring it into the shower, other HAs you can. If you want to keep your hearing aids 3-5 years, avoid water at all costs and also try to protect it from sweat if it is a RIC or BTE.

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  • Why in God’s Earth are adult hearing aids only widely available in such. HIDEOUSLY UGLY colors? Why do they INSIST on limiting the adult colors to hideously awful colors, even when you offer colors for juvenile hearing aids? Why do they refuse to let adults order the colors available for kids? Why do they think all we want is wimpy white, blah beige, boring black?
    The industry was making such progress in this area a few years ago, and then, suddenly they all went back to the dark ages of blah colored hearing aids again. Is it THAT DIFFICULT to offer a little color?

Hahaha yes, I know what you mean. They limit the amount of colors to control the stock on the shelf. My assumption is that it is related to the pandemic and the supply chain being limited. Companies at some point may have thousands of RICs on the shelf and it is easier to sell them all off if they are generic colors. I’ve seen some pages on Etsy that can add decoration to them that I found cute.

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  • Is it true that if I buy a bottom tech level aid, all the higher level functions are still in it, just switched off?

Yes, that is entirely true. I also suspect that is not limited to the hearing aid industry.

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  • Why is such widely-available technology so expensive and the phone apps so terrible?

“Why is such widely-available technology so expensive”

Let’s say the bill of materials for a pair of devices is between $300-$400. I’ll list some factors I know of that pumps up the price in chronological order.
Research and Development of the hardware, firmware, fitting software, etc. is very expensive and involves 100s of engineers and a couple audiologists to validate.

The manufacturing process is of the devices and shipping adds a little

This is an FDA regulated medical device so every little process is more scrutinized and this drives the price up.

Audiologists sell the device to the consumer and make a huge margin of profit

“phone apps so terrible?”

I agree that the phone apps are not great. Most patients don’t use it and wouldn’t even use it if it was perfect. Development of the mobile apps are difficult because most of them use “Bluetooth Low Energy” protocol which does not have a great connection compared to my consumer headphones but it uses significantly less power for the hearing aid. There is also always a lot going on in every hearing aid app, they are inflated with so many features that need to work that the fundamentals don’t receive enough love. The future may change with a greater demand with the demographic now becoming more technologically aware.

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:face_with_spiral_eyes:

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I wonder just how many app developers have a hearing loss and wear hearing aids. Developers that don’t have the need for hearing aids don’t have the understanding of the needs of someone with hearing loss and wear hearing aids.

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Excellent post. Thank you

Whoever designed Phonak Audeo Paradise P90 HAs has never worn hearing aids. Waxguards are atrocious. Domes are two. My dispensingaudiologist couldn’t set them up. Had no issues with Phonaks for previous 10 years

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@DaveL You are very welcome :+1:t3:

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I question just about everything that Phonak has put out over the past 15 years since the Quest (Q) series aids. They were the last Phonak aids that I was ever really happy with. It seems to me that they have declined in quality with each generation since. Clearly, they were not designed for those with my hearing loss in mind. Same thing with the Bs. It’s like every new generation of Phonak aids are quieter and quieter. I can only assume the reason is due to lesser quality - in just about every aspect of the aids - every time.

I am really, really happy with my new Oticon Xceed 1 UP + CROS UP by comparison.

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I was wondering if Phonak is aware that so.many users are in “pain” because of this lack of quality …
Can’t we just send them this big thread to them?

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I also curious about Oticon, currently investigating Signia …

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I am a person who will always advocate on color choices! I know phonak has started to add some color options to the RIC Lumity line but as for other devices such as BTE and older models they do not offer them. It’s unfortunate because as a young person it reintroduces the stigma that my hearing aids should be hidden or have to match my hair/skin (which they never actually do). Adults deserve fun! And having aids that are easy to stand out against floors or a table certainly helps if they are dropped, being used by someone who has vision issues or just needs a much larger reminder of what side is the left and what side is the right.

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If we look at hearing aids prices:

The average current price per pair is around $7200
And the average paid as per their survey per pair is $4672
If we average both data, that would be $5936, for a sake of argument $5900.
Assuming the cost of parts $400 and all manufacturing/testing/accreditation costs $400, total = $800
That means $5100 goes to the hearing care provider!!! (including taxes)

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well said, beautiful :heart_eyes:

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You could get half the pair of a midrange aid for that money wholesale with a 40-50% discount, add on the charger and your service/insurance, plus the cost of your Audiologist and premises.

Top end, you’re a couple of grand short.

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I was thinking the audiologist’s cost would have been around $2000 max.
I guess that’s why some are un-bundling their packages.
Not sure how much here in the UK.

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Thanks for sharing this; it’s very interesting!

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@birdcountry99 You are very welcome. :+1:t3:

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Will follow your investigations with interest!

no message and some extra words

No.

Only added this sentence to meet the twenty character requirement.

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No. The systems engineer is telling us that the bill of material is $400. Then goes on to say that R&D and other indirect costs that the manufacturer incurs are large. And s/he gives no breakdown of how large. The only thing that can be determined from what is stated is that the difference between what the customer pays and the B/M is due in part to indirect expenses and profit at the manufacturer, and the rest of the difference goes to the provider. There is no way based on what was stated by the systems engineer to determine how much goes to the provider, and it certainly isn’t anywhere near $5K.

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@Torbill Are you saying that the HCP will get much lower $$$$ than $5K?

Note: it’s not that I am against HCP earning +$5000, I am for HCP to earn a living and make some money in the process, they are absolutely free to put the prices they want.

As a consumer I want to know who takes what in the bulk of the sum I am paying.

You could take KS10 for example, $1400 a pair at Costco, assuming that Costco takes up to 25% margin, $1400 - $400 = $1000 @ 25%, meaning that Costco will bag in $250 and the manufacturer will get an extra $750 per pair, which is $1150 goes to the manufacturer.
Assuming $5900 price tag per pair, HPC will be charging $4750 per pair, that’s 80% of the hearing aids price per pair, and the manufacturer will take the remaining 20%!!!

You are making the assumption that a local clinic has the same buying power as Costco. I agree that what is charged to Costco allows some profit to the manufacturer, but I also suspect that local clinics pay significantly more than Costco for HAs.

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