I feel for the private business audiologist in the US. Kind of a catch 22 situation. Such a small percentage of people who need aids can afford them, few have hearing aid insurance. If the prices came down, more people who need them would get them and the private business audiologist would get busy and make some money.
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This topic comes up fairly often. Seems like it’s the audiologists that get the blame, but I really think it’s the business model–individual practitioners in any field are a dying breed because they can’t compete with high volume practices.
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From the start, there have been huge margins in the audiology field. Many private practice hearing centres get away with selling only 2-3 pairs per month to sustain operations.
With some digging I found that the list is for a combination of the States of Minnesota, Wisconsin, Michigan, Maine, and Colorado, with an estimated purchase of 8,111 aids annually.
Other price lists can be found here:
https://www.maine.gov/dafs/bbm/procurementservices/reports/statewide-contracts/hearing-aid-contracts
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Gotta love the internet.
Evaluating and prescribing are indeed clinical functions carried out by many professionals. Evaluating, prescribing and then SELLING items is conflict of interest, dual role activity, IMHO. Requiring payment in advance for services yet to be rendered, and, likely never to be utilized, is at least unethical. Failing to advise a consumer of so-called “professional medical/audiological services,” in advance, that “30 day trials” will require full payment up front with a likely failure to refund $ attributable to “fitting” services, if returned, may well be actionable at a licensing board. Performing the removal of a CIC, Lyric 3 leaving the “patient” with bleeding ear canals, still not healed in one ear, worst case scenario, will be actionable in civil court.
Take aways: Require from a audiology clinic resource: full disclosure, up front, as to bundled v. unbundled prices; full disclosure as to when payment for devices is required - recommendation is to undergo REM (and if clinic doesn’t do REM, disappear) and repeat audiological examination with hearing aids installed, comparing hearing w/ aids and REM and Speech in Noise activated, against initial hearing test so as to determine whether or not, and to what extent, the significance of the audiological change is worth the $$$$.Sign no contract if your visual scan of the outcome, coupled with your personal experience of the effects of the change in device does not justify the cost, and, if not, leave that joint. Last: avoid Lyric if you have small and convoluted ear canals and an audiologist who is lowest on the totem pole of providers in that particular clinic.
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I am going to say something that slaps the face of some of this. My first hearing aids were purchased online and I was sent to an audiologist to fit the aids I purchased that had no knowledge for those hearing aids. So I would be very happy to go to an audiologist and have that person to sale me the aids that that person knows how to fit and service. And I will never purchase online again.
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I am leery of purchasing ANYTHING online, but especially things of a medical nature. Unfortunately, in some cases, online is the only viable option.
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I have no issue with purchasing CPAP machines on line. $800 on line is a much better deal than $2400 at a sleep clinic. A CPAP is much easier to monitor and set up yourself compared to a hearing aid.
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Perhaps what we’re sometimes saying isn’t that we can’t hear, but the cognition factor is the issue. It certainly is with me.I was directed to Oticon 3’s. In a controlled atmosphere they are better than my original Costco. My West Springfield MA Costco guy, Chris was fantastic. When my hearing got so he could find no way to make it better, he suggested I see a eye, ear, nose MD. So far, they’ve not been able to do much better. I’m told HA aren’t perfect for everyone. I am continuing my search for better cognition.
Dick T
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Easy to say such things…
but the other side of the coin is this: Did the hearing aids do what was intended?
Over the life of the hearing aids, most people will spend 3 or 4 times the cost of the hearing aids eating chicken strips and hamburgers. Some of my patients spend 12k a year to belong to their local country club to play golf, and drive up in $75,000.00 cars.
To spend 7k on something that can preserve one’s speech understanding, keeps them involved in the things they like to do, and potentially reduce cognitive decline and the risk of dementia is nothing in the grand scheme of things.
Now if you spend that kind of money and are treated like crap, then there is a genuine concern. But if you pay that money, are treated well by qualified professionals, and are getting results, it is worth MORE than what you paid for it.
Just one man’s humble opinion after almost 25 years in the business.
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I’m living on Social Security and a small pension. I don’t belong to a country club. I eat out about twice a year, and that is for lunch, not dinner. Buying new aids is a hardship I put off as long as possible. I drive a twenty year old economy car. I consider myself fortunate in that, somehow, I have been able to buy aids as needed, but I don’t consider them well priced. There are people who are much worse off than I, and I’m not sure how they can afford aids. I am not good at negotiating prices and, rightly or not and feel the hearing aid buying process is, very much, like stepping into a car dealership. Costco seems, in many respects, more fair.
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To be fair, some car dealerships, even some used car dealerships, are fair and honest and you can get good service and good deals. You just have to find the right one. Same with audiologists, and psychologists, and medical doctors, and ---------
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SS…
Starkey has a program called hear now which is a charitable program that gets hearing aids for people that cannot afford them. As a single person, you have to make under $24390.00 a year, can’t have a bunch of money sitting in a savings account or anything like that. If you qualify, it costs you $250.00
It might be worth checking into.
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And that $250 is about what they cost Starkey to manufacturer.
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That is the approach that makes many people uncomfortable and frustrated. It is trying to price hearing aids on the potential benefit, instead of on the costs of research, development, marketing, and fitting.
Say a person makes $500,000 a year and goes to the Chevy dealer. If the dealer said this Chevy is going to get you to work for 10 years and therefore help you make money, so at a price of $200,000 it is well worth it based on the benefits you are going to receive, wouldn’t you be uncomfortable and distrustful?
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That is a bit of an underestimate.
The cost of components may be in the three to five hundred dollar range, but the cost of developing the aids goes well into the millions. in 2015, Starkey spent Somewhere in the neighborhood of 400 million dollars buying machines so they could build components in house.
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Unless the manufacturers are going broke, it’s fair to assume that their wholesale price includes all costs. This article Hearing aid prices much higher than their actual cost | CBC News put that price at $500 CA a few years. We also know that premium aids are sold to Costco for something much less than the $750 US each they sell for retail, likely about half of that. Therefore I would speculate that the unknown costs of research, development, etc has to be less than $100 per aid, and probably more like $20. Or perhaps a case can be made that Costco is freeloading? 
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Actually, Costco and the NHS in they UK are essentially doing just that. The cost of a BTE hearing aid to the NHS is about £60-£90, this assumes that all of the R+D has essentially been paid for during the period that the circuit was at a premium and secondary levels.
The premium margin pays back the R+D, the secondary margin (Costco) - makes the bigger circuit fab economical and the tertiary margin - NHS and 3rd World and run-out essentially covers component costs only.
The secondary and tertiary levels only exist in terms of the volume in these markets with fewer options and flexibility of form.
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Businesses in the private sector exist to make profit. Without profits, no hearing aid company would be alive to make hearing aids.
Costco is a poor example because they were able to negotiate huge discounts based on the thousands of units they do every month. The average hearing aid dispenser small business may do 20 hearing aids a month. When you figure rent, insurance, equipment, maintenance, utilities, and employee salaries into the equation, those profits evaporate pretty quickly.