I want to ask a question. Smartphones have more hardware than hearing aids, but hearing aids are still more expensive than mobile phones. What could be the reason?
Much lower volumes?
A lot more personalized fitting / support?
Historically (in the US) hearing aids required a prescription and audiologist to fit / support?
I am new to hearing aids and learning about them but my assumption is the OTC category of hearing aids established by the FDA in the US is an attempt to address the cost and accessibility. The OTC hearing aids are (much) cheaper than prescription hearing aids if you have mild to moderate hearing loss.
Hopefully over time some innovative and cheaper products will emerge in this category. While smaller than Smart Phones the market opportunity is still significant (30 million in the US according to the FDA)
3 Likes
I think it has way more to do with amortizing research and development costs across a much smaller market than with the total amount of hardware.
Hearing aids are necessarily very specialized devices, with different design requirements than smart phones.
Size/miniaturization, battery life, harsh environment, consistency of output over time, etc, etc.
A more apt question might be âwhy does a smartphone cost more than my 65â smart tv?" They perform many of the same functions, some even run the same basic electronics and operating system - but the TV has a screen roughly 200 times larger.
7 Likes
I posted a French breakdown of the costs of HAs here a while ago (see below). Shockingly, the price of the hardware PLUS R&D is just a few hundred dollars. The bulk goes to the audiologist.
7 Likes
Absolutely correct, give or take 
I think the cost of the aids to the provider is very dependent on whether they are massive international business, a bigger local business, or the onesie small independent provider. Volume purchases change the deal to the provider. I donât think it is fair to assume the prices are flat across the industry.
WH
I think a lot of the cost of a phone is subsidised by the carrier to lock you into buying overpriced cell service. Iâd like to know why my eyeglasses cost as much as a phone.
People run scared
Hearing aid manufacturers know itâs a medical electronic item and make the charge 10 times more at least
There are millions of more cell phones being so than hearing aids that changes the price.
Look at the price of a hearing a charger it is more than the most expensive car battery charger.
Over-the-counter hearing aids is designed to reverse this process
For yourself go purchase a set of Apple AirPods Pro 2 https://www.hearingtracker.com/hearing-aids/airpods-pro-2âs At $154 program them to your hearing a test and learn more
1 Like
Simple Spock Logic
Hundred of millions of people want smartphones where only a fraction of that want hearing aids.
Add to that the limited number of HA manufacturers and you have the perfect storm for âprice gougingâ. OTC aids will help bring down cost, but donât hold your breath hoping for a good quality hearing aid under $500 a pop. Pigs donât fly and neither do smart phones.
1 Like
Thatâs still a pretty big number. And only a fraction of those that want hearing aids actually get them⊠and the main reason for that is they canât afford them. Miniaturisation might have had traction as a valid reason thirty years ago. Itâs a protected market. Thatâs my take.
2 Likes
Thatâs way out of date: a modern set of high end aids will cost somewhere around two grand (ÂŁ) wholesale. (How long has the Siemens name been out of the industry too?)
Even if you could double that at retail, which you normally canât; (Spheres from Specsavers are ÂŁ2995), you have to cover the cost of your clinic, staff, Audiometers/REMs, computers, training, loans and tax from it. That puts the Audiologist pay wedge of the pie, at somewhere between 12.5% and 20% depending on how the business is structured. Ok if you turn a couple of million - but not so much if you only do a couple of hundred thousand.
Apply the same model to dentistry with ÂŁ30 worth of amalgam or titanium screws and a ÂŁ150 crown set. See what the âprofitabilityâ is like there.
6 Likes
No, above diagram was published in â60 millions de consommateursâ in 2022, not that long ago. But, yes, it reflects the situation in France, where HAs are far less costly than elsewhere. Last year I bought my Phonak AudĂ©os P90 just across the border in Annemasse for about 1,500 USD apiece (incl. fitting & charger). Here in Geneva (and the US) they are typically sold for over double that price.
My hunch is still that the percentages (as shown in the diagram) in those countries are about the same, but the cost breakdown of HAs seems to be a well-guarded secret.
3 Likes
We have talked about this many times in the past, the manufacturers keep the price artificially high, volume sales to the likes of the VA, NHS & Costco are a different kettle of fish⊠From past experience, I once had access to the NHS price catalog, the NHS are paying around 1/20th of the high street price, I have no way of knowing if this has changed? At one time the NHS were the largest dispensers of hearing aids worldwide⊠For the independent Audiologists, they get screwed, they probably canât buy in wholesale for the price that the likes of Specsavers are selling for, Phonak Spheres, fully fitted for ÂŁ2995 for the pair⊠IMO, the manufacturers keep the price artificially high, basically they run a cartel, yes they have R&D costs, yes they have overheads, but you are probably talking the actual manufacturers costs, is probably around ÂŁ50 to ÂŁ100 tops per aid⊠and thatâs a very conservative estimate! Now, I can buy a set of ear buds, for my wife, I have bought a few sets, Bluetooth 5.3, with noise cancelling, perhaps 30 hours or more runtime for around ÂŁ25, those Chinese manufacturers are still making a profit and transporting them thousands of miles⊠Someone is making a killing, but I beg to suggest, itâs not the the local dispensaries! Cheers Kev 
4 Likes
If true (and I donât doubt you) - then the independent Audiologists are getting screwed (as are customers working with them). It does make sense as Costco can evidently sell similar specâed hearing aids for a much lower cost (presumably a result of a volume purchase agreement).
The equation does change for those who can use OTC hearing aids in the US. Here the customer is buying direct (and getting online support) from the supplier in a market that will encourage competition.
1 Like
Possibly this explains why HAs can cost less than half in France of what you pay for them in most other places (like I said, except for above diagram, HA cost breakdowns are a well-guarded secret).
Like for medicines, manufacturers probably use national distributors to charge âwhatever the market will bearâ, in the absence of any other constraints. Upon FDA approval there is almost no state intervention in the US, which has thus become big Pharmaâs Eldorado and the de facto funder for worldwide R&D in medicine.
An important difference with medicines, however, is that hearing-impaired patients may simply decide to opt out, i.e., not buy any HAs, as they cannot afford them and you do not die from not wearing these things. I suspect this (costs) is a major reason why there is such a massive under-use of HAs globally.
I am not a marketing expert, but the whole concept of pricing, sales volumes and profits is imho ripe for a reviewâŠ
3 Likes
On my province hearing aids are provided at no cost for hearing loss >35db. There is a very limited number of models to select from and they are not the very last technology. I was told that the one I was provided (signia pure 312 3ax) have replacement cost about 3000$can a pair, and that a substantial part of the cost is the specialist fees. If we want higher end technology it is around 8000$ and then the price of the device itself is very high. When we buy phone, the latest models are also much more expensive compared to older versions.
Even with provided hearing aids, many hearing loss people still dont get them. So I guess cost is just part of the story âŠ
2 Likes
Provider should just send you to Costco.
Reminds me of Ontario discounts for wheelchairs. (20 years ago) Government paid a ton but patient still ended up paying almost what the chair could purchased for outside of the damned system, which seemed to be designed to waste money. A retailer admitted to me that the scheme was a mess but claimed that without the income from the program he might go broke. It led to ads for barely used chairs that were âworthâ $5k being sold for $100. Hopefully theyâve fixed it by now. At time I remember reading that Quebec was making improvements in their system.
2 Likes
Just to make it clear, I havent paid at all for my aids. But if I lose them, they donât pay the replacement. If we want a model that is not on their list they dont pay at all. So I was told by the hearing aid specialist to start with the provided model, and we will evaluate if it is worth paying for the extra features in a few yearsâŠ
3 Likes
That sucks and itâs another reason the provider should contract with Costco as an option to the current system. Top tier aids with full service for about 2 grand retail in Canada including free replacement with no deductible. Seems to be about a third less than the provider is paying now for mid tier devices without insurance. The savings to the government could be used to expand availability. Might be worth a letter-writing campaign.
2 Likes
Apple have been miniaturising things for years to cram them in and create a phone that does hundreds of things. Cameras, camera lenses, antennae, NFC chips, RAM, SSDs etc etc. If you only want a phone that simply takes or makes calls, you can buy one as small as a match box.
AirPods Pro 2s are just a warning shot in what will be coming from Apple for people who are hard of hearing.
I predict that they will have a solution for many people with tinnitus in the next couple of years.
1 Like