This guest post on hearing aid costs was contributed by Ed Belcher*, who put together this eye-opening, neat piece of analysis.

Did you ever wonder why a hearing aid costs up to 6x more than an iPad? Peeling the onion on the cost structure of both devices reveals an eye-opening comparison into the dynamics of either industry. It can provide us with pointers on where the future price and cost tags could (and should) shift.

Hearing Aid Costs vs iPad Costs

Let’s assume a high-end hearing aid costs $1000 to the audiologist when he/she buys it from the manufacturer and consequently gets sold for $3000 to the consumer. Now if you dissect the $1000, based on a study by the German Competition Regulator, the following total cost breakdown emerges:


Now, let’s take a closer look at the iPad: a recent study at the University of California, Irvine took a closer look at the cost structure of a regular iPad and came up with the following segmentation:


Bear with us, as we plot these numbers on a chart:

hearing aids prices

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The manufacturing and distribution hearing aid costs are upside-down in comparison to the manufacturing and distribution costs of an iPad.

The iPad is subject to hard, unfettered competition. Its manufacturer profit, marketing, R&D and dispensing costs combined take up 45% of the retail price.  The production cost takes the balance (55%) of the retail price.

Most hearing aids are made by the Big-6 consortium which shares patents and does business in a mutually beneficial way. The prices of hearing aids sold by dispensing businesses are around 3x their wholesale cost. In that case, the production cost of a hearing aid comprises only 8% of its bundled price.  The remaining 92% is made up mostly of dispensing fees, administration salaries, and profits.

Granted, the market structure is different for both products. For instance, the sheer sales volumes of iPads far surpass those of hearing aids: Apple sold 3 million iPads in the first 72 hours of its recent launch. By contrast, 3 million units are what the entire hearing aids industry sells in one year. This sales volume allows for different economies of scale, especially when it comes to retail.

Furthermore there is a more involved service component attached to hearing aid dispensing (however not as much as what is traditionally claimed). Hearing aid dispensing, based on personal experiences when shopping in varied businesses for hearing aids, took 1 hour for the exam and discussion of HA options; 1 hour for fitting and training; and up to 2 hours for up to four 30-minute adjustments/training, a total of 4 hours of contact time. Assuming $100 per hour, consultation should yield a total of $400 in dispensing service fees.

In any case, the comparison is still startling and should raise questions on whether the industry and hearing aid costs are really operating at its most favorable level for the consumer. Let’s look at the next piece of analysis.

Hearing Aid Costs With an iPad Cost Structure

The aforementioned hearing aid that a dispenser buys for $1000 costs about $250 to make, as we saw with the previous example. So we start with the $250 production cost.

If the iPad-structure were followed based on the $250 production cost (i.e. 55% of the total) then:

  • The final retail price for one hearing aid would be $250 / 0.55 = $455
  • If the specialist sells two aids for $455 each and adds $400 for four hours of service, a pair of high-end hearing aids would have a price of $1,310

Let’s pause here and put this figure into perspective: $1,310 is equivalent to 22% of the traditional $6000 for the same pair!

What does this calculation imply on the audiologist revenues per customer? The $455 retail price includes a 15% markup (same as the iPad) of $68.25/aid. The total proceeds to the dispenser is 2*$68.25 + $400 = $537 for each customer served.

The questions that remain are thus:

  1. Can industry prosper and sell aids for $387 (0.85*$455)?  After all, they have sold millions of aids to the VA with prices decreasing from $375 to $333/aid from 2004 to 2011 respectively, according to Lucille Beck, Director of Audiology, VA, and The Hill
  1. Can a specialist prosper with a 15% commission for aids sold and with a $100/hour rate for services (normally 4 hours) during and after the sale of the aids (i.e. $537 of proceeds per customer)?

Tell us what you think; we would love to hear your opinion!

* Ph.D. EE, Career researcher (retired) in underwater acoustics at the University of Washington

Sources: German Competition Regulator, The Economist, MSN Money, Lucille Beck, Director of Audiology, VA, The Hill

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by Patrick Freuler

106 responses to “Why Does a Hearing Aid Cost Six Times More Than an iPad?

  1. I have Starkey he’s. I paid $5500 with 3yr warranty. It has been ~2.5 yrs.
    Lost one and found about 6 mos later.
    Lost because they never stayed in well.
    Lost many times prior but was lucky to find. They charged me $800 to replace in the meantime. They switched to a different rubber end that goes in the canal and haven’t had any problem losing since.
    Now I have misplaced or accidentally threw one out. I really don’t want to pay another $800 with only 6 mos warranty left. I think they told me before that they wouldn’t reactivate the original one I later found.
    I think the one I still have and the original are the same ear if it matters.
    Anyway I need to investigate my options.

  2. Thank you for sharing this information. It was useful and interesting

  3. Great article, unfortunately it falls on deaf ears in the industry but certainly tells people to shop around and more importantly buyer beware. I live in a border city in Canada and my aid in the US was$1495. compared to -are you ready- $4250. Exact brand and model but no free batteries in Canada. The audiologist actually gasped when I told her my Canadian quote. I have found through my recent medical experiences , health care is just a business like anything else ,big business. I recently read an article regarding dentists and this can hold true to most medical professions , beware of a medical office who dissects your health care benefit provider package before your barely in the door. Looking to line their own pockets even if treatment is not needed. A real eye opener!!

  4. I’ll just say this. I just built a workstation. Wacom drawing tablet. High end Sennheiser communication headset. Gamer keyboard. Gamer mouse. One of the most expensive consumer grade cpu (Ryzen 1800x). One of the most expensive consumer grade GPU (geForce GTX 1070). One NVMe drive (250GB). Two SSD (1.5TB total). External drive for backup. Blur-ray burner. Expensive gamer motherboard (Crosshair Hero VI). High speed gamer ram with RGB. Expensive full tower case (Corsair 760T). 3rd party cooler for the cpu. The cost? Less than my dad’s brand new Oticon Opn 3 (5k). Anyone who doesn’t think it is ridiculous is out for lunch.

  5. To keep cost down for consumers – Manufacturer of hearing aids can just provide free apps to consumer to program their own hearing aids via ipad or pc. Eliminate the middle man and just go to an Audiologist for hearing test and fitting.

  6. I’m the one who played in a rock band for 19 years on and off, but it was my poor wife who ended up with hearing aids at age 67. We checked out Costco which had somewhat “reasonable” pricing compared to the audiologists recommendations. We were shown very excellent aids ranging from $3,000 to $6,000, and ended up paying $4,000 for Oticon programmable with Blue-tooth capability. Medicare paid for the audiologist exam, but neither them or our supplemental insurance paid for a thing. I know she will need new aids in maybe 10 years so I guess I need to start saving for them now. As stated above by other folks, this is a real racket, with all the companies in lock step to keep the pricing fixed at ridiculous costs.

  7. I recently went to audiologist for a hearing test , she tested my hearing . fitted me as to the size and was paid by my insurance co. paid very well. Now she wants to charge me 6000.00 to put the aids in my ear. She already did all that needed to be done. What allows her to charge that much?

  8. With so many aging Americans I am wondering why our congressman and Senators haven’t done more to see why these devices can not be sold retail. Like insurance where the public hasn’t a clue about what is involved so goes HA sales and they can baffle us with _ _.HA that last only a short period of time is outrageous /vs / the costs.Rise UP Seniors and let your elected officials know how dissatisfied you are with this debacle.

    1. They have! They passed a bill last year for HA to be sold OTC!

  9. Hearing Aid pricing parallel: There was a printer who needed his nonworking printing press fixed. He called the specialized repairman. The old repairman spent about 15 minutes looking around the press, flipping a few switches, and tapping a few gears, then he was done. Gave the printer his bill, $1,000! The printer, incredulous, yelled at the repair man, UNFAIR! All you did was tinker a few minutes! I demand a revised bill! Quietly, the repairman revised the bill, and itemized it to read: “Tinkering: $1. … Having the right tools to tinker properly $10. … Knowing Where to Tinker: $989. (On-site Service call – Free)” Of course, this doesn’t factor in all the repairman’s overhead or any professional association and continuing education dues or licensing fees.

  10. I have worn hearing aides. I only wear one now, occasionally. I was unaware that the lifespan of hearing aides is sooooooooooo short. My one hearing aide died after about seven years. I was careful to keep them stored in a drying agent, and to keep them dry and clean. Plus they were the BTE type, so they did not have the nasty environment within my ears. Yet, I experienced the upper end of a hearing aide’s lifespan. I find that totally unacceptable for a $6,000 price. But I have no sense of humor left for the totally ludicrous price of hearing aides.

  11. Consumer Reports Magazine and AARP (American Association of Retired Persons) are two organizations that should be leading the charge on serving the public. Sending a letter and a used hearing aid battery to your national senators and representatives would be helpful also. We need a lobby group. Has to be a mass movement to dislodge a profitable entrenched system.

    1. This is why I contacted AAARP. They need this info on the profit companies are making and how so few monopolize the market.they should be publicizing the new Congressional Law.i have talked to many and they know nothing about the OTC law.i found out be accident when my Audiologist was angry about it.that is when I began to research.

    2. Air bags in cars have Gold (real gold) in the electronics device so corrosion won’t be a issue…You would think this would be used in HA’s…

  12. Same here, I am paying almost CAD 3400/- for Only one Hearing Aid and a Transmitter for the dead ear.

    2016 05.

    1. I intend to contact 60 minutes and ask them to do a investigation of why these devices are so expensive…It is my hope they will do a report on this.

  13. Your numbers look to be spot on. I had a hearing test and got the two for $6000 figure too. Got a second opinion and the quote was almost exactly the same,seems this figure is the price of admission. When told the average life of a hearing aid is five years that means I will be spending at least $18,000 if I live 15 more years I am now 71.
    I need hearing aids I think everyone is entitled to make an honest living but this is not honest, its another captive situation.
    If I supply the aids the price is only $200 per aid to set them up.I had a hearing test May of last year. She told me I would need to be retested since its been over 6 months. I was fitted for a demo May of last year cant use that information either.

  14. l have been inside several different hearing aids and I would be surprised if the parts cost more than $25 and all the other costs are more than another $25. One should be
    able to sell them for just $200 at a good profit. Look inside a cell phone and see the difference.

  15. I guess this situation is the result of charging what the market will bear and as supply only meets demand at such a high price, it then prevails but millions who need hearing aids are left out. Capitalism is perfect for the rich & disaster for the poor.

  16. Audiologists should go back to school — and train with hard-of-hearing people, not textbooks and graphs. Most of them don’t know a damn thing about a hearing-impaired person’s environment. Their office is not even set up to ‘mimic’ a real world – be it an office setting, home or any ‘real-life’ environment that we all have to live in. They have a quiet setting and ask: “Does this sound better?” or “We can’t help you anymore, we tried all the settings, I think it’s time for a new pair…($$) We’re hearing-impaired, not idiots.

  17. What I think? I think it’s an outrage. The industry monopoly is out to make big bucks on the oncoming aging population, particlarly in the western world. When you can’t hear (and you need to work, or hear your children cry so you can pick them up), what choice do you have? No one seems to give a damn.

  18. I would commend you for your research and analysis. About years ago, I went to a Miracle Ear franchise for a new HA for one ear. I had a good one for the other ear. The owner sold me a digital unit for $1,700.00. It worked great. Two years later I moved to Tennessee and needed to replace the HA for my other ear. I went to a local Miracle Ear dealer hear. He attempted to sell me a much more expensive one, and I said I wanted one that performed like the one that went bad. He said that they didn’t make them any more, and wanted $2,400.00 to replace the one I owned. I went back to the original dealer and was able to buy one for the same price as I paid for the first one. That is unusual. My experience since then is that they all use MSR pricing with no discounts.

  19. Don’t care what you say, hearing aids are way overpriced!

    1. Hi there!

      We agree and that is where we come in to offer much more reasonably priced hearing aids. Our hearing aids range between $499-$699 per ear, compared to the thousands of dollars that hearing aids are priced locally.

      Give us a call if you are interested in learning more. Our phone number is 888-979-6918.

  20. Unlike an Ipad, hearing aids are a life changer. Without them we can be isolated and cut off, so the high prices essentially have us as a hostage.
    I can’t afford hearing aids so have to use a phone app as an amp with some earphones.
    Charging over the odds for all electronics like computers, phones, tv’s etc.. is one thing. But when its a life essential like hearing aids, glasses, or a walking stick- its really taking advantage

  21. For the hearing dispenser who said his costs were too high and couldn’t support his costs ithe his $8000 monthly income: you admit that you only had 4 sales during the month. As another writer stated it takes about 4 hours of a dispensers time to test, sell and service a hearing aid device. That implies that you are objecting to working 16 hours a month or are reluctant to take a second job. To the individual who cited going through 9 years of medical school for his training: why are Hearing Aid Dispensers accredited to do the almost identical work and they need very, very little training. To those who say it requires a big tech understanding why did the industry lobby so vigorously to have Hi Pro and other programming systems taken off the market when so many individuals found they could easily program their aids with these devices?

  22. The GAO figures it costs the taxpayer about 12,000 USD to fit someone with hearing aids costing the V.A. about 800 USD….And the VA does not have to “market” their H/As….I also take exception to your service #s…..the average private practice fitting involves about 8 hours of initial counseling, and an hour or so three to 4 times a year, for the life of the H/A….the consumer paying real out of pocket money, will not tolerate the substandard service that our veterans receive….try and work in the real world, you will soon find out what I’m talking about…..most full price dispensers will even make a hospital, or nursing home call, if necessary, at little or no cost…

  23. It’s what the market will bear. Remember when glasses were a ridiculous price? Now on line companies can supply a top quality pair including prescription lenses for around $70. It won’t be long before they will be doing the same with hearing aids. The average person worries about their hear loss and think there is some mystique involved in supplying what is a fairly simple amplifier; as if the wrong hearing aid will damage their hearing. The only way that would happen if it is too loud. I’ve spent about a $100,000 on aids in my lifetime so haven’t any sympathy with these suppliers with fancy white coats and other paraphernalia they adopt; acting as if they were medical specialists.

  24. How about $50/hr and 2 hrs.!

  25. $3000. – $4000. dollars every couple of years for inferior performance is taking advantage of those that need hearing help to to continue functioning in life.

    Not being able to hear what is being said is not only frustrating it makes people look stupid and foolish to the point they withdraw from life.

    The exorbitant prices of hearing aids, eye glasses and dental are price gouging by any definition…with hearing aids being the biggest rip off at every level of the process.

    Being that the majority of these users are older people mostly on fixed incomes is even more detestable.

  26. There would be a lot more sales of hearing aids if the prices were reasonable. I was quoted a price of $8,400.00 for 2 hearing aids, and I am NOT profoundly deaf. There was talk of needing that top hearing aid as that was the only one really effective at controlling crowd noise. This is terrible marketing and manufacturing practice, if true.

  27. It has been a while since I have posted here and there have been a lot of interesting posts. I still firmly believe that the actual manufacturer is sticking it hard to the audiologists.(If what they are saying is true what they pay to the man. for the devices)
    My experience with dealing with health insurance and what they will or will not cover really sucks. They consider a hearing aid a prosthetic device and for some reason won’t cover it. They cover eyeglasses, knee and hip replacements etc. etc… Maybe it is how the devices are bundled into the cost of the service of the audiologist? I don’t know. I do know when I saw my orthopedic MD for my knee replacement all of the services and hardware involved were billed separately. AND the insurance carrier itemized the payments and co-pays as well.

    The hearing industry is so in the ice age. Not with their technology but coming to grips with the actual cost and markup of their devices. Audiologists should not be retail outlets for devices but be suppliers of what we need for our hearing loss and they should be able to charge (as a medical provider) a price that is billable to insurance carriers that allows them to earn a living as a trained licensed professional.

    I hope the rest of you chatting here are doing well with your devices. If you aren’t satisfied with the sound of your hearing aids, don’t give up! go back to your audiologist and work with him or her till you get it right.

    Being a musician I am really picky about how mine are programmed. With my knowledge of frequencies, compression ratios and response curves and how they affect the response of my devices have allowed me to sit with my audiologist during programming of 4 different settings allowing me to hear properly in a normal conversation, noisy environment, on stage and listening to a loud concert. Your audiologist wont know what is bugging you if you don’t communicate with them.
    Good luck!

  28. Two factors would determine how far it can go to reduce the cost of hearing aids. 1, whether a mold is used to fit individual ears, (best choice for optimum fit) or the current trend of flexible, easily changeable entrance cones. The molded feature is certainly more expensive and time consuming, also requiring some skill in making the mold and hand fitting the electronics. Using the flexible cones becomes an off-the-shelf item, such as might be found on the shelf at a drug store. See where I’m going here? 2, It is argued that a high percentage of people who could/should use a hearing aid, do not do so due to vanity or embarrassment. Whereas, I argue the real reason is the present super high, totally unreasonable cost. The level of mass production always effects the cost of any item, so, since I contend that by lowering the cost to an affordable level, many more would be sold, the manufacturing costs per item would go down and the masses could hear again. Even with your assumed scenario above, where the cost per aid is “only” $455, certainly far more reasonable than now, I think it could be lower. However, by doing so, would mean the business of being a hearing aid specialist, one would do it as a part of another function.

    My ultimate solution is first, have a doctor check your ears for physical damage, wax build up etc., just to see if aids would be advisable. Then, to have kiosks in the drug store, where one could enter a booth, put on the earphones and push a button to take the tests. At the conclusion of testing, the optimal choices for style would be shown, the pharmacist would unlock the cabinet, take out the aid(s) and put it in the programming box where it would be set according to your specs. The box would contain different sizes of cones which you could select for best fit, put them in your ears, pay the man $125 and be on your way. No insurance, if you lose one, you buy another By saving your prescription you don’t even need to take the test, or, if it has been a while, you could go in and test just to see if anything has changed, and pay your $15 for the use of the kiosk. Now we have to get the Government to remove the classification of “medical device.”
    Obviously, I have simplified the process, but the approach is valid. It may not work 100% of the time, but those details could be worked out.

    The consortium of a few makers of aids or aid parts helps maintain the research and keep prices high, and the business retailers, those who maintain high rent offices for no other purpose, are what keep prices high. An aid manufacturer was once asked if he could provide aids for $50 each, and he said yes. You only have to buy one million of them. Mass production, didn’t Ford think of that a while back?

    Thanks for starting the bandwagon on the right track, maybe that’s why I’m wearing Audicus, but would be wearing something else if I could find it. Has anyone seen a HAK lately? (Hearing Aid Kiosk)

  29. I have purchased three sets of hearing aids over the last 15 or so years and have always considered them massively over-priced. None of them were very good at processing music and were marginal at regular speech. I still misunderstand much of what people say to me and sometimes repeat back to them what I thought I heard but in a twisted sort of way. Kind of like gallows-humor since hearing loss is so frustrating and alienating.

    With all due respect for the manufacturers of these complex devices, and dedicated, trained audiologists who populate the hearing aid business, I was, and continue to be shocked at the outrageous prices they charge. I considered them all to be ‘pigs feeding at the trough’ before I read this article. Now, that’s confirmed. After my second $4500 set, I resolved to speak with my credit card and keep it in my wallet if the price was too high. That didn’t last very long when I needed a new set. The price of being half-deaf is alienation so I paid what they charged and bought a replacement set. I found few alternatives but managed to shave a few hundred off the price.

    As for audiologist visits, if I could adjust the levels myself, I would do so and skip the visits. The whole process is frustrating since they operate the controls and make changes based on what feedback I give them. All this happens in an ‘ideal environment’ so when I go out to the real world, the settings don’t work as needed.

    I would like to see Apple come out with a hearing aid product that I could set up and adjust with my iPhone and have them blow the doors off the entire hearing aid industry.

  30. why is it I paid $2400 for 1 hearing aid in Ca but see the prices much lower in Nevada

  31. The hearing aids the VA give to the Veterans are the cheapest on the market. I have used them for over 5 years. Next year I am going to buy my own on the outside. I have spoke to friends that have purchased theirs on the outside and they love them. Mine suck when I walk in the mall.

  32. Hi all. I am a product developer in this field and the truth is more insidious than you would like to know. I was recently in a meeting with a former employee (more than an employee, he was a VP) of one of the biggest hearing aid manufacturers in the world and he spilled the truth. There are 3 main manufacturers of the 3 necessary components of every hearing aid. The 3 main companies work together to keep the prices artificially inflated. He told us stories about how they would have annual conferences that were supposed to be geared toward driving down the cost of hearing aids, but instead would be champagne-fueled parties with gift baskets and oysters, celebrating their success. They have spent years making certain that hearing aids remain FDA regulated even though PSAPS have identical technology. Seriously, I’ve been making products for years. Hearing aids are EASY and CHEAP to make, with 3 basic components and an outer casing. They are not magical or made of unicorn blood. What’s happening here is similar to how DeBeers controls the diamond market. I feel bad for the audiologists and for the public.
    Costco is breaking down some barriers (Siemens, ReSound couldn’t resist the siren call of the volume potential) but that’s not enough. It’s almost like a Michael Moore-type needs to take on the industry and expose it for what it is. I’m doing my best to bring some more affordable options to the market, but I know that I’m in for some resistance….here’s to the future!

  33. Why does our FTC allow this collusion and price gouging to continue; especially when the prime prey for these predators are the elderly on fixed incomes?

    1. Elizabeth Warren and Chuck Grassley passed a law last year that Hearing Aids could be sold OTC.why do you think you are getting so much mail?Medicare Advantage policies are now paying $3000 a year for Hearing Aids.

    2. Hi Joseph,

      I wish I knew the answer to that! It seems that someone or many people stand to make a large sum of money off of this system. Hopefully, companies like Audicus can change this and make hearing aids more accessible and the industry kinder.


  34. Thanks for sharing such an info via blog. Recently, the audiologist whom i consult regularly in a reputed audiology clinic in Toronto has diagnosed that i’m partially impaired. And prescribed me to wear a hearing aid which will be fixed behind the ear. But comparatively as you’ve cited in the blog that hearing aid are expensive than iPad is not so true. I have purchased my hearing aid at a very reasonable cost. If you’ve been charged 6 times expensive than iPad, then you should be aware that you are being unnecessarily canvassed by any brand.

  35. The easy solution to high costs would be to have audiologists reasonably charge for their services but not sell hearing aids. They should charge appropriately for the services they provide but the hearing aids could be sold by companies such as Best Buy. Unfortunately, there are many examples of health professionals who retail products at very high markups. I would rather deal with someone who isn’t interested in retailing products but instead is providing their very best services in an unbiased way.

    As for the cost of hearing aids. It is easy to go online and do a search of electronic components (assembled) and you can see that prices are a tiny fraction of the retail, often less than 10%. I have a Siemens bluetooth hearing aid transceiver that I paid $400 but found it on for $35. If the retail market were to be opened up you would find the retail costs of hearing aids drop off a cliff.

    My daughter needed a CPAP machine which the local pro wanted $2500 but we found it on line for $600. Same machine. Google is your friend…

  36. Hi It gets even worse in the UK
    We pay in £ Sterling what you pay in $ Dollars. ie we pay twice the over inflated extortionate price.

    Then if we try to beat the system and buy from the USA, the British government charges us 40% in import tax and duty.?

  37. Great article and astute comments. People are not fools — greed is always obvious. The extortion is troubling; and I’m not sure I understand Scott, the audiologist’s quandary. The smaller percentage of people, “but a full 38% said No!!”, who wouldn’t buy, have their reasons. It’s your job to find out why; but 62% is not a bad market share.

  38. Very interesting article. As I have watched smart phones, I pads, etc. develop I have often wondered why a better, cheaper hearing aid is or has not been developed for market.

  39. The iPad is a product people can relate to cost wise, but perhaps a better channel comparison would be vision/eyeglass related. The cost of my last pair of glasses was similar to my Audicus hearing aid. (I am fortunate I only need an aid for one ear, it would be great if a pair of aids cost similar to high end glasses, easy to equate) There are optometrists and eye wear shops in most large malls apparently doing well business wise. How different is the vision care product and business model from hearing care?
    I understand that lenses and frames are low tech devices compared to hearing aids, but I suspect today the manufacturing and R & D cost are similar. Time for a change?
    I suspect a service provider like Audicus could dramatically change the existing business model by piggybacking on a vision care centre and offering “would you like a free hearing evaluation with your eye checkup?” Has this been tried recently? I know I wasn’t aware of my poor vision until I was tested and experienced what was good. I suspect most people simply do not know what is good hearing as they do not have the simple opportunity to experience it.
    The only people who can justify the current end user cost of hearing aids are the people selling them and the users who absolutely need them.

  40. There exists quite a mix of opinion in this thread. On the one hand, I agree with the person who said that as long as there are enough people willing to go into a traditional hearing aid store and shell out US$3-5,000 for a pair, the business will continue to operate just the way it does now.
    But that’s not the whole story. For the past ten years, I’ve been wearing a pair of Rexton Targa 2P hearing aids that I got from a strictly Internet reseller (which shall remain nameless) for $675 apiece, plus the support required to make the ear castings for the custom earmolds, and support ever since for tubes, batteries, etc.
    Now I need a new pair of hearing aids, but it’s the same old story in the traditional industry :just pay us $50 a month forever, and here you are. No go. Since I’m a veteran, think I’ll go the VA route this time…..or if I don’t qualify, maybe to Costco or back to the place where I bought these. I am part of that percentage that refuses to pay the kind of money (whatever the reason!) that traditional hearing aid stores charge.

  41. This is a really interesting article. It is definitely something worth looking more in to. Thank you for bringing this to light.

  42. Are Audiologists putting themselves in the same class as Football, hockey baseball and all overpaid atheletes then that’s why hearing aids are costing so much. Sell at a lower cost and sell more. 6,000 dollars per set is only for these atheletes. Average people cannot afford them. In other words I have to be a baseball player with that salary to be able to afford them

  43. I don’t know how many of the comments made here are from the hearing industry itself. To make a claim just don’t buy hearing aids. It will bring the cost down. If you suffer from severe hearing loss like I do you might as well not get out of bed every morning. You won’t hear the doorbell ring. You might not hear the phone ring. And when you do answer it you won’t be able to hear the person talking clearly….or at all. The TV has to be turned up loud. With captions which is annoying to someone else living with you. My first pair I bought about 10 years ago. I managed to hang unto them for 9 years. With many repairs at about $150 each. They had cost me $4500. The same place has been trying to sell me a new pair for over $5000 which I truly needed because of newer technology. I finally had to buy a new one when there was no more hope for the old one. It turned out I am deaf in my right ear. So only needed the left. I went to Costco and bought one for about $1300 a year ago. So far happy with it.
    Costco’s prices are less than half than the industry standard, despite the fact that its hearing aids are produced by the same major companies, including Rexton (a brand made by Siemens) and GN ReSound. Its in-house brand of aids, Kirkland Signature, is also built by Siemens. And unlike many private hearing aid dispensers, Costco employees don’t work on commission.

    1. I agree with what you say. Even,taking into cost checking and cleaning your Hearing Aid every 3 months during the warranty process does not justify the $3000 cost. Yes, I found out about COSTCO from a young woman at Church. She had moderate loss in one ear, severe in the other.they have an Audiologist , free cleaning and checkups.$1599 for a pair.she is thrilled with them.the changes in the last few years should have lowered the cost by half.

  44. It is a crime that hearing aid manufacturers/dispensers can charge (rob) needful clients when their costs do not merit the selling price of hearing aids. As you have compared to iPad and the same is true of smart phones.
    What can be done about this? I am on my 3rd set and have spent enough to buy a car.

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  46. Interesting to read how we compare similar high-tech products in different user markets. In which I believe is not fair to the consumer. The basic principals of business are positively correlated in each industry, even cost structure. The basic principal/benefit to supply and demand is to build quantity to lower your cost, even is you are building an ipad. Whenever you mass produce anything, ipad, hearing instruments or widgets you are going to have your cost to scale in your production. Therefore I believe the philosophy in comparing an ipad and hearing aids is somewhat flawed. Remember, Apple avoided producing a self funded dividend so it would not have to move capital to US from Europe and incur a 38% corporate tax hike on that capital. So, Apple borrowed the money at a 1.5% rate and paid their investors. My point is Apple has a larger margin on its product then what is being assessed.

    Therefore correcting the model stated above with the difference in cost the two products are financially similar in nature. If you were to put in front of a person with hearing loss an ipad and a set of hearing aids which would the individual choose? My guess would be the ipad, because you can always turn the volume up on the ipad and compensate for the hearing loss. And, the ipad is cooler then hearing aids.

  47. What so many people have failed to mention is how the technology has changed with each generation of products. 20 years ago, the number of people who found success with hearing aids of the time period was staggeringly small. In the neighborhood of 20-30%. Customers properly fit with current model, premium technology are experiencing success rates upwards of 80-90%. Why do you think that is? It is because the technology has improved immensely, even within the last 3-5 years. Those improvements aren’t just the size of the devices, but the level of clarity and speech understanding. Devices are also more durable than ever thanks to hydrophobic coatings that prevent corrosion and degradation. Comparing a hearing aid to an ipad is ludicrous. An ipad is not typically used constantly for 10+ hours per day, as hearing aids are. An ipad is not used in a 98.6 degree, humid environment that is constantly shaking and moving, as hearing aids are. And ipads do not require any real training to learn how to customize. My 3 year old figured it out in a few hours. But a 3 year old cannot begin to understand how to program a hearing aid. In addition, size DOES matter. Lets see how well all of those electronics inside the ipad work if we miniaturize them down to fit inside a hearing aid. Imagine paper-thin ipads…. Don’t you think the price might go up a little bit? In addition, as pointed out above, the article doesn’t take into account how many customers each day walk into my office needing hearing aids and refusing to buy them, AT ANY PRICE. Just for my own personal information, I have offered customers $6000+ hearing aids for $500, and the customer will still insist they cannot afford them. If that is truly the case, then why did they even come into my office and take up my time? They must have known they could not afford anything before they walked in the door. But never the less, I still have to pay my receptionist, my office manager, my marketing coordinator, my IT support, etc….

  48. I agree the hearing aid companies are making the money but the audiologist make good money too, not as high a % as the companies that manufacture the HA. The cost to manufacture is low maybe $100.00 The companies are ripping us off. Something should be done about this. That is why medicare doesn’t cover these items.

  49. Yep, the iPad to hearing aid comparison is pretty terrible. Now if I had thousands of other products and hundreds of customers a day like a Best Buy, I would take that 15% retail profit. The only product sold in my office are hearing aids. That is what I focus on solely is hearing. In your chart you shows costs for the manufacturers but represent everything as straight up profit for the retail side.

    Am I working out of my car here with no employees, no customer acquisition costs, no equipment costs, no utilities, and on and on?

    If the percentages were comparable to the iPad and we had a 15% markup, that would mean we make $6,000 over the cost to purchase the instruments in an average month. My monthly expenses are roughly $50,000 to keep the doors open. When it is all said and done……I make about 10%-15% in reality. If $4,000 per set of aids went straight into my pocket with none of it taken out, I would be retired by now and I have only been an owner for 6 months.

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  52. I have been practicing audiology for 27 years. I have 9 years invested in my college education, 7 of which were devoted to audiology. Audiology is the lowest paid doctoring profession. Believe me you can make just as much money coming out of school with a 2 year technical degree as you can in audiology with a lot less debt than our new grads are incurring today. That said you can be ” fit” by a hearing aid dispenser with a high school diploma, 3 month apprenticeship program and passage of a correspondence course type test. For all of you that want to buy your hearing aids by mail that is available (run risk of under amplication or damaging over amplification). For all of you bargain hunters you can go to your big box store where you buy your bulk toilet paper and be “fitted” most likely by a dispenser (non professional).They may even be a former stocker, baker, cashier who the store put on a fast track to becoming a hearing aid dispenser by their big box employee. They aren’t exactly going into the field to help people hear but will be lured into the field by the 50 to 60 K they can make vs. the 15 to 20 they are making previously. For the rest of you who may care that they are getting a professional hearing evaluation, a hearing aid that is prescriptive based, a referral to a medical professional for potentially life altering/threatening conditions, and professionally trained counseling skills to get you through the transition of wearing hearing aids…….see an audiologist. (American Academy of Audiology and American Speech Language Hearing Association are good resources for the consumer). Ask your audiologist if you are getting a bundled vs. unbundled price. It is a fair question. I know most people feel my professional time is valuable. I gladly pay my physician, chiropractor, dentist, optometrist for their time and they have contributed immensely to my life. I hope you will feel the same when you see an audiologist.

  53. I have been practicing for more than 19 years. Mostly private practice. I can assure you the profits are not what many people think they are. I wish we could sell them for less. I survive on referrals and some advertising but cost are high. If we sell them for less I might as well close the doors. Our average ASP is $1,800 per unit. That is as low as I can go. I’m trying to fit people with high end technology but can not sell it for less.

  54. Brian, If your offices are paying $2200 a pair (at your cost) for devices then I would have to say the manufacturers are sticking it to the Audiologists. Thank you for doing your best to keep costs down for your patients.

  55. i feel like a sucker and probably is….. i purchased a top of the line pair of hearing aids at Beltone at a whopping $6,200. anyone interesting in buying ?

  56. I own two hearing clinics. We started in April of 2012 and through personal sacrifice and continued investment, we opened our second clinic in August of 2013. Our price to consumers are on the lower side of the industry average, but are not far off from the example that you mentioned in your article. What does seem to be severely off is acquisitioncost of “premium” Iinstrumentation. Our volume is considered high at 60 units per month between the two clinics, and our cost of acquisition for top of the line equipment is still about $2200 for a pair. Our first year in business, my take home pay was $23,000. In year two, I have improved that to almost $50,000. I am very proud of the way that we do business and the help that we provide to people in need. The only people on this board who should be ashamed of themselves are the ones voicing such a strong opinion on a matter that they are not qualified to chime in on.

  57. @ Caitlin Rock, Au.D… Thank you for the reply. I am familiar with what you are describing as the powerful computer chips within the hearing devices. Their RAM capabilities for external programming from a computer to customize their EQ, Compression ratio and other parameters. Still in this day and age the total production cost per aid can’t (in reality) exceed $200.

    If the Audiologist were to NOT bundle aid cost with their in office fees and return checkup fees I believe people with hearing loss might not be as gun shy of getting help. Also maybe health insurance providers may also look at this differently and cover the office visits.

    If you were to see the advertised price of a VW Jetta as $42,000. including all service and repair for X years as opposed to $21,500 and a choice of where to take it for service what would you choose? I know what I would choose.

    Believe me, I have choked down the cost of wearing hearing aids and I admire my audiologist for the care I get in their office. Fortunately I am able to afford the service and devices. I also know many who can’t. It is time to draw a line in the sand and call a spade a spade.

  58. As this is my profession let me break down some number for those in disbelief at the cost of hearing aids. My cost on a top of the line hearing aid is $1,400. I sell that hearing aid for $3,400. With our brand you will receive free service for the lifetime of the hearing aid at any dealer throughout the United States. For my patients I see them once every three months at min. to clean their ears, clean the aids, reprogram the aids ect. Out of the mark up we have we run right at $300 Gross Profit. That number fluctuates depending on the number of units dispensed that month. More often than not it is much lower than that due to high advertising costs these days. To say that anyone is getting rich from dispensing hearing aids is not the case. The manufactures are the ones making the big money in this industry. Those in private practice dispensing do not make the money people think we do. I’m in no way defending the price of a hearing aid but simple facts are that we have to sell them for these prices to keep our doors open. For those who can’t afford there are programs in place by these local practices that can get you the help you need for little to no cost at all. You will never know about these programs if you never go and talk to them.

  59. I have worn hearing aids for 20 years and am also a sociologist trained in research. I have specialized in the medical arena and also have worked in public health prevention and education for years. I have NEVER heard the issue of hearing loss come up in public health and obviously this impairment can affect the health care encounter and many other issues. Part of this is federal and state health policy, which siloes issues of aging and disability and public health into different sectors and funding streams.

    Has anyone done qualitative and quantitative research on why people don’t wear hearing aids or even if they care if they’re invisible? I don’t really get the latter issue, as it does not seem to apply to vision loss. Is it somehow the “deaf and dumb” label?

    I don’t buy that there’s some inherent flaw or willfulness in people not wearing hearing aids. I went to four different ENTs(affiliated with elite teaching hospitals) in the years after I was diagnosed. Not one of them nor their affiliated audiologists gave me any education at all on wearing aids, what to expect, how to cope, etc. The first audiologist sighed and said,“Oh, you’re so young.” Big help.

    As far I’m concerned, the biggest psychosocial issue around hearing loss is powerlessness because of ignorance, lack of education and stigma. Virtually everything I have earned I have learned on my own. You can’t even find info on coping at the bookstore! I firmly believe if people don’t wear them that is because they have not been given sufficient education about the brain, adjustment, options, etc. I wore mine because I had to in order to work and I was told that the brain would forget to hear if I didn’t wear them.
    If people had sufficient understanding of hearing aids, were given them at a reasonable price and had “buddies” to coach them thru as we have for so many chronic diseases, we would be in great shape. I think it’s an absolute disgrace how much they cost and how little education there is.

  60. Patrick thank you for a eye opener article exposing the ripoff and monopoly of the hearing Aids industry. If you google H.A. you wil hear countless sites where people are sharing the same frustrations that are found in this blog. I’m 63 and served in artillery during the Vietnam era conflict, later in the 80’s I served in the reserves for many years. I do not qualify for VA hearing aids because I’m over their income guidelines, but still, I’m too poor to afford hearing aids. I’m on medical disabilty and have medicare plus my empoyer Insurance and neither cover H.A. or even the exam. If they are medical devices, why the insurance or medicare does not pay for them is frustrating.
    I’m on my third pair, first one from miracle ear, another from Costco and the third a gift from my niece who used to work for a hearing aids manufacturer, she bought them at dispenser cost of around $250. each. They are now beyond repairs and I need a new pair but can’t afford them.
    I call on dispensers that are visionaries and willing to take a risk and do things outside the box. I read dozens of books of such people, including the founder of wallmart, and others. Sell the aids from a vending truck if you have to, offer excellent service, start with 0 staff and by word of mouth you will have so many customers that you would not need advertizement.
    I read an article from the NY times and it listed a hearind aids dispenser who also repairs hearing aids, working in the back room of a shoe store. Several people have asked for his information so they could go to him, so far the author has not responded, the point is, word of mouth is the best advertizement.
    I also would like to ask, what can we, as people who have a disability but cannot afford a device that can help us do to resolve this preventable tragedy?

  61. I would suggest that the X factor that is not understood is that the amplified sound produced by hearing aids is in the first instance not very pleasant, so unless an immediate benefit is realised by the wearer they are very likely to reject them.

    So what can be done? focus on methods to achieve an immediate benefit upon the first fitting.


    >Scott wrote:

    >August 21, 2012

    >I am an audiologist (wearing body armour so the inevitable rock throwing won’t cause >permanent damage) and would like to make one comment related to barriers to hearing >aid use. We still don’t understand why people will not accept hearing aids. Price, stigma, >appearance are relevant but there are other unknowns. The Better Hearing Institute did a >survey several years ago and asked hearing impaired people who were not hearing aid >users this one question: If you could have hearing aids for free that were invisible and that >would solve your hearing problems, would you wear them? 62% said yes but a full 38% >said No!! With this scenario we address cost (free), we address cosmetic concerns >(hidden), and we assure benefit – and yet 35% still didn’t want hearing aids. Why? What >is the X factor that we still don’t understand? I don’t know but it points to the problem >being more complex than we currently understand. That said, 62% penetration is much >better than the 20% we’re at right now.

  62. @ Rick O’Neill “the basic electronic components might cost to the manufacturer of the device $5 – $15. The molded earpiece is probably most expensive because of the plastic extrusion machine used. Even at that a pair of molded ear plugs are $40 retail. Pretty simple electronics folks.”

    Rick you may be familiar with a standard amplifier but hearing aids these days contain powerful computer chips. The computer chip is what increases the prices of the unit – not the microphones or the receiver, those costs you are correct about. These computer chips that the hearing instruments contain are literally capable of performing up to a million calculations per second to analyze the environment and increase the signal to noise ratio (SNR) in order to give the hearing impaired individual a better chance at hearing conversation – they use a non-linear system to apply gain. The chip looks at soft, average, and loud speech and applies the prescribed gain or volume at the individual frequencies based on the hearing impaired person’s hearing loss.

    As for professionals feeling ashamed of what we charge – most audiologist bundle their costs. So your follow up visits and any in house maintenance for the device are “free” as are the extra supplies needed to keep the devices running. We have a front office staff to pay, equipment that needs calibrating once a year (quite expensive to keep up), rent, utilities, ect… All of this is rolled into the example of 2000.00 markup. It’s not dishonest – nothing is free. As for myself, to be more transparent about the costs involved with the device I have unbundled the pricing so that you can see what you are paying for. I can’t necessarily speak for all professionals but I think that most Audiologists are in this career because we realize hearing is a vital part of communication and we want to help individuals and hearing aids are the way that we can do that.

    Hope it all works out for the best!

    Caitlin Rock, Au.D.
    Doctor of Audiology

  63. Great Blog! Thank you! It has blow me away for years how hearing aids can be so costly. Like Mike, I am also a musician and also dabble in Electronics. Let me sum up the components.. A molded ear piece, 1 or 2 microphones, a speaker (audio driver), a level control (volume), and an OP Amp pc Chip. Also some are fitted with a pushbutton switch for changing settings and now some with Bluetooth capabilities. The basic electronic components might cost to the manufacturer of the device $5 – $15. The molded earpiece is probably most expensive because of the plastic extrusion machine used. Even at that a pair of molded ear plugs are $40 retail. Pretty simple electronics folks. Maybe 20 years ago these items might have cost a few hundred bucks but in the day of pocket pen digital camera and flash drives that hold more information than a $3000 computer did 20 years ago only costs a mere $10-$15 for 16 Gb. So where do they get off charging so much for the device.. I can see the audiologist charging what a doctor would for their in office time like and other doctor would but if you went to your GP with a broken finger and needed a $5 splint you sure as heck would not have to pay $500 for it.. That is my example of the markup we are paying for hearing devices.
    And for the professionals here trying to justify what you charge for the hearing device…. well you should be ashamed. Your services are appreciated and you deserve to make a living from your services… Not rip off people in need so they can hear again.. Ashamed.. It will only be a matter of time that someone will step in and put a stop to this smoke and mirrors snake oil business.

  64. This works for some who try it. Of course not for wearing ALL the time, but still useful: there is an iPhone app called iHear. Turns your iPhone into a hearing aid with your ear buds or any headphones on your ears. Cost???? 3 bucks! Works for my father in law. A few people wearing these and the price will start going down. Probably a programmable app in the future.

  65. The Number one reason for these ridiculous prices can be laid at the feet of our fine, best, money can buy politicians, that have declared these are medical devices. Now WHO did these corrupt politicians do this for, US their Constituents or for the Oligarchy they work for? CORRUPT Government intrusion is OUR number one problem in this country. I despise all of them, they care for only one thing from us little people, that is a VOTE.

  66. Okay, I live in Germany. I bought a pair of aids 8 years ago for 3000 euros the pair. You suggest that the audiologist got 2000 euros. Or 250 euros per year. For that I got about 3 hours’ worth of initial advice and initial fine-tuning, plus a free cleaning service as often as I need it, usually about once every nine months. And two hearing checks since. No one else can do these things. I find it cheap at the price. My ENT doctor charges 60 euros just to syringe my ears, and that’s pure routine. That’s a rip-off for you — a quarter of what the audiologists gets, for a five-minute procedure.

  67. I purchased my first pair of hearing aids several months ago. Upon analyzing the bill, I found it to be the biggest rip-off I’ve ever experienced. The dispensing fee is outright robbery and this fee was not explained up-front.

    The procedure of buying hearing aids is not like buying shoes, or other things which you can try before you buy, due to the fact that you can’t just try them on off the shelf. Shopping around is difficult as the various features and terminology describing different brands becomes confusing as they all seem to have different terms for similar features which makes them more difficult to compare. Collusion seems evident given the hearing aid cost and the dispensing fee rip-off.

    Someone should open a chain of stores selling hearing aids using the structure in the article and advertise the cost analysis. I’d go there – who wouldn’t?

    As for adjusting hearing aids, surely there is a program which could be installed on a PC to allow the user to tune the aids him/herself. ???

  68. Online purchase of hearing aids? I need to replace my first set of hearing aids. I love your blog and the great information. I understand that one can purchase them online. Any help, cautions, experience?

  69. Hi,
    I am a Musician.I can purchase the very best Brand amplifier and a hand made exquisite guitar for less than the price of two of these hearing aids.The guitar and amp. will last a lifetime with a little tlc.I can prove this as I have two that I purchased in 1962 and they still work perfectly and are now valued at 40000 dollars,I kid you not.
    Hearing aids are a total rip off.They should be priced at just a couple of hundred Bucks/Euro/Stg.I need aids big time but not enough to pay these silly prices.
    These people will keep selling these aids at these prices as long as people are foolish enough to buy them.
    We are being ripped off .Hearing aids should only be dispensed by qualified health workers
    who’s best interests are the health of the patient.

  70. Many comments from dispensers argue that hearing aids are expensive because of their cost to dispense. In my blog

    third entry down, dated Oct 2, 2012, and titled “Dispensing – Profit versus Quantity and Efficiency,” I consider the expenses of dispensing. I present a hypothetical retail franchise that does very well for its employees and owners as well as provides excellent service and premium products to its customers at prices between 25% and 50% currently charged by private practices.

  71. The comments here are diverse and interesting. However, my experience having gone to Sam’s club is that the top and hearing instrument, Which cost $4000 for hair with four year warranty, is a good deal compared what you can get that and audiologists that his having to work in a high Overhead office.

    I came away thinking it was pretty ridiculous to purchase a device that was no more expensive to produce than a flip cell phone. Even with Sam’s providing the overhead support for the audiologist and the advantage of in-store advertising to people walking by, the price was still way too high for the product.

    It will take more than Sam’s and Costco to break the current model of overpriced hearing devices. A device that is manufactured outside of the current cartel would be free to provide technology that is driven by demand and not the needs of those controlling the market a monopoly.

    Because there is a huge market that is not being exploited, I believe there is little doubt that there will be a dramatic change in the way that hearing instruments are produced distributed et cetera. One example would be the Bluetooth capable hearing instrument that could be completely operated and calibrated by an application that would run on your iPhone iPad or other smart device. There was nothing that the audiologist at the Sam’s Club where I had my appointment did that could not be done by using an application, iPad, and Bluetooth conection… To calibrate and adjust the instrument. The remaining support issues would not require an audiologist trained technician.

    The bottom line, I expect that the whole model for selling hearing nstruments will change dramatically in the coming years. Obviously people that need hearing instraments are mostly in there 50s and up. As the younger generation’s approach the time when they may need an assist, they will not accept the ridiculous price structure that is currently in place due to industry and regulatory structures defining all aids as medical devices. Self programmable devices need not fall under the category of medical instruments.

    With all the above said, there is still no need for audiologists to be left out of the circuit so to speak. The insurance industry’s legitimate role of covering specialized professional audiology services would enhance those professions by restructuring the compensation model away from the reliance upon the sale of hearing devices.

  72. Is it just me or do others find it hysterical that people are typing in all caps on a hearing aid forum.
    I am aghast that audiologists are defending the price of hearing aids by the small number they sell. Does it occur to anyone that they sell a small number because they are so expensive? Apparently no one discusses market dynamics in audiology school.
    My mother is 95 and needs new hearing aids. She can hear OK but not as well as she could with new hearing aids. This has been going on for a few years now. She knows that new ones are a minimum $4000 and her attitude is that she hangs around with old people and they have nothing interesting to say anyway.
    The point is that she would have replaced them twice in the last four years if she was not being gouged, but she says no, don’t waste the money.

  73. I find the price to be a total rip-off. First of all why incorporate the cost of research into the market price? Research is the cost of doing business. Suck it up. I can buy a head set with noise suppression and automatic gain control for less than $100. A sophisticated notebook computer costs me a lot less than a cheap hearing aid. I have worked in electronics since the days of vaccuume tubes and making mini parts is not expensive these days so don’t say small size is the big cost.They have cameras the size of pin heads these days for $100. Hearing aids are a rip because theyare controled by the market. They have a market with no competition and customers with no other choice. If you can’t make a profit then you boost sales, boosting sales is done by reducing prices and getting rid of your three BMW’s.

  74. Thank you very much for sharing. It is great for people to know and understand the breakdown of why a hearing aid costs so much. I think that this will help people be more understanding when buying a hearing aid. It is a great investment and will be worth the money. – Hearing Aids Colorado

  75. I see the point of this article but as some other have said here, it doesn’t show the full picture. It looks like middleman is just a greedy guy for charging those prices.

    I live in Europe but i’m guessing this isn’t going to be much different.

    – I have to pay a rent (workplace not living place)
    – I have to pay for water
    – I have to pay for light
    – I have to pay for security
    – I have to pay an insurance
    – I have to pay my employees
    – I have to pay my own advertising and marketing (And the marketing & advertising cost of the manufacturer based on this article, why do i buy it for 1000 and not 250 which is the production cost then?)
    – I have paid all my equipment to properly do audiometries
    – And for the rest of the comfortable place i want you to visit so you will stay
    – I have paid my studies to be an audiologist
    – And i need to keep myself in constant formation of new tech, discoveries, articles, etc…
    – I’m investing time with the customer before and after the deal
    – I have to pay taxes for working, for having a worplace, for being an audiologist, etc etc etc
    – I´m sure i forget something

    So there you have my costs after i bought that hearing aid for 1000. Indeed the middleman is costly but it’s also there to get your problems fixed (at a cost or not) and much more accesible.

  76. Cost is not he number one reason people do not purchase hearing aids.
    It ranks as number seven.

    One person commented it is because of greed that prices are so high.

    You need to walk in my shoes for a year and then you might understand how foolish that
    statement is.

    With operating expenses of $8,000.00 per month, not including my income of $30,000.00 per year, i need to sell 12 units per month to keep the doors open. All last summer i sold 3 or 4 units per month. Just got a tax bill from my county for $800.00

    No longer sure i will servive in this business. I have been here in business in this area for over 25 years. Still working and trying to earn a living at 72 years old.

    Maybe i should give up, join Obama’s followers and go on welfare, and food stamps.

    I am far from getting rich selling hearing aids, and i am tired of working.

    Like i said…… try doing the job for a year, then tell me how greedy i am.

  77. I am a senior of 71 years of age with hearing loss for the last 30 years or so. My income hinders me from buying hearing aids because the price is considered by me as one of the biggest rip-offs together with gas prices, glasses, dentists…
    My hearing is getting worst to the point of having to abandon my only past time of singing in a choir.
    If I had my way…

  78. Interesting, amusing, part good point part not.
    Let me say a couple of things
    First, I am a qualified hearing aid audiologist so I do want earn more than an iPad retail geek. But more importantly you quote for a $250 hearing aid and then call it top end which is not correct. A low end hearing aid would cost that. A top end aid, to me is £600-£700 approx, plus vat. Convert that to dollars then redo your sums. Oh and I reckon over 5-10 years it’s an hour a year at least with each client. I’m interested to know how your revised sums look.
    To those who are disappointed with your hearing aids please remember… Your hearing is damaged and a hearing aid is not curing the problem so can only work as well as the ear responds. In the uk we give a money back guarantee so no one has to buy an aid they are not happy with.



  81. I am now on my second set of top brand hearing aids. Neither has been
    satisfactory in delivering the quality of sound that the extreme cost should provide. I’m sick of Mickey Mouse voices, whistling, plus beeps of battery failure. I,m sick of these expensive devices falling of my smaller than a man’s ears. I’m sick of having to put my glasses on to install batteries. I’ve lost two aids forever because they do disconnect from your ears without notice and with insurance you still get dinged with deductions. My current audiologist has charged me $200 for initial installation and brief follow up and I am getting muffled sound in one ear.
    I can’t believe, in this scientific age , that hearing aids can be made better
    and for less and with better, convenient design, especially for women.
    I think if aids were more efficient, better designs, and less costly more of us need of them would rush to the market place. My experience leads me to feel hearings are a scam. Now that I am far into retirement I can’t afford this expensive help and will soon be isolated from normal activities in my community. In the next world, I’ll learn lip reading early in life so I’ll be ready for weary ears.

  82. Price is our biggest barrier. I’ve put off for years dealing with my hearing loss because our insurance doesn’t cover any part of hearing aids. Now my 15yr old daughter needs them due to a genetic disorder (not from listening to loud music!) and we’re afraid we won’t be able to get them for her due to the prices! Price is definately a barrier!!!!

  83. Excellent article/post. Let me add a couple points:

    1. One critical difference in your analysis that you didn’t go into is the level of training/licensing/education in the “retail” end of the hearing aid business. Because hearing aids are classified as medical devices, the persons allowed to distribute hearing aids has been carefully controlled by state licensing boards, which are controlled by current practitioners. This creates limited number of outlets for the distribution of hearing aids “safely” to the public.
    2. The creation of the AuD degree for audiologists was a move to raise the level of professionalism in the dispensing of hearing aids as well as improve the professional standing of audiologists among other health care providers by making it a “doctoring” degree. At the same time it increased the income expectation of those audiologists.
    3. Your “retail” section of analysis ignores the business operating costs of the audiologists and hearing aid dispensers. The advertising/marketing costs you show are for those of the manufacturer only. The retailer must also advertise and the costs are a significant portion of the retail cost of the product. Further you are ignoring the rent, administrative costs and other operating expenses of the retail practitioner which have to come out of their “retail” portion. It is not all “profit.”

    Simply lowering the price of hearing aids will not create more demand as Scott explains. Retailers would be the ones who would have to bear the risk of reducing their margins in order to generate the “expected” revenue and the market is littered with the bones of businesses who thought that they could accomplish the necessary volume/price tradeoff only to find that the market didn’t reward them sufficiently for their dramatic price reductions.

    There may be some movement in the future to sell hearing aids more “directly” to consumers or with minimal professional involvement, like United Health Cares abortive attempt earlier this year, but you can count on the established interests of audiologists and hearing aid dispensers to oppose any threats to their “license” to sell hearing aids.

  84. I am one of the many who suffers from severe hearing loss but cannot afford the ridiculous high price of decent hearing aids. I am only 33 and have suffered hearing problems since primary school. I have previously undertaken free trials only to learn I cannot afford the actual purchase (being over $5000 for the pair). Now, this sucks in ways that the hearing aid companies may not realise. The main concern for me is the extreme difficulty I have in the workplace. I was (until a few years ago) an award winning chef, with bucket loads of potential and intelligence, and for years have been extremely passionate about beginning a career in counselling and psychology. To begin my career, in 2006 I began a double degree in social work and human services only to learn I couldn’t understand my lecturers! I left the course out of frustration and instead joined a concreting crew so I could be in a job surrounded by loud blokes who never use big words which makes them easy to understand. As far as I can see, this country is missing out on many people with passion and potential due to its unhealthy love affair with capitalising on peoples unfortunate circumstances. Shame on you, audiology
    “companies”!! And don’t get me started on dentistry…

  85. I am an audiologist (wearing body armour so the inevitable rock throwing won’t cause permanent damage) and would like to make one comment related to barriers to hearing aid use. We still don’t understand why people will not accept hearing aids. Price, stigma, appearance are relevant but there are other unknowns. The Better Hearing Institute did a survey several years ago and asked hearing impaired people who were not hearing aid users this one question: If you could have hearing aids for free that were invisible and that would solve your hearing problems, would you wear them? 62% said yes but a full 38% said No!! With this scenario we address cost (free), we address cosmetic concerns (hidden), and we assure benefit – and yet 35% still didn’t want hearing aids. Why? What is the X factor that we still don’t understand? I don’t know but it points to the problem being more complex than we currently understand. That said, 62% penetration is much better than the 20% we’re at right now.

  86. Thanks for all the input everyone!

    @Ramon: thanks for the comment! the traditional channels come with a lot of face time and servicing that ultimately finds its way into a bundled, final hearing aid price. This variant might work for a lot of people… but there has to be more choice for those that can’t afford it.

    @Mike: price is most certainly the #1 reason, followed by stigma and aesthetics. Currently there is still a lot of inertia for people to shop around and become informed about there being more affordable alternatives available… which is why you won’t see an immediate increase in volume because of a price drop. The minute there is more price transparency, prices will be impacted.

    @Harold: thanks! we’re very much looking forward to your launch!

    @Mae: great comment, lets get the word out and let people know that there are viable alternatives out there.

  87. Great article and with professionl documentation. I have purchased a couple of hearing aids when my wife and were working, One lasted 4 years. The ones I have now are beyond repairs and both sets were $5,000. Now I am in neeed of hearing aids but do not have the resources to pay those kind of prices.
    I moved to another states and tried to get audiologist to adjust the hearing aids and most refused, because I had not purchased from them. I found a couple of audiologist later on and they charged me $100, which I was gladly wiling to pay, Except both were not trained by the company that made my hearing aids, so they never ot them right.
    I ran unto a friend who used to work for a major hearing aid company and he told me the similar information that you stated and I was in schock.
    Recently I posted in a hearing aid blog about what my friend told me of what is the actual cost of hearing aids and it seems people don’t believed it.
    There is such a thing as profit, I can understand that, but when you have a business that have the market corner and in a sense have people that are in need of medical devices hostage to the outrageous prices, in my opinion , It is not free market or making a decent profit, it is as they said in the vernacular ” highway robbery, or out of control greed”.

    What I like to hear is what can consumers do to get these companies to be more compassionate and ethical in their pricing of hearing aids, you quoted 28 million people that need these medical devices that they can’t afford. People will continue to sacrifice and buy hearing aids even with high prices, because they have no choice, without them, your whole life is affected.

  88. Patrick:

    Great blog, excellent information. We at Audiotoniq, Inc. support you in your efforts to bring this very important issue to the forefront!

  89. Awesome post. Not only would hearing aids sell but the increase in sales would be exponential. What is the number one reason for NOT getting hearing aids? I’m not an expert but I’m going to go with cost.

    1. Exactly the reason I have not moved on aids.

  90. Great Article. Having worked in NYC Advertising for a number of years I can truthfully say if people willingly pay high prices for hearing aids, high prices will continue to be charged. It is obscene. Only when folks stop paying through the proverbial, will the price drop. You just have to get the word out that you don’t have to support highway robbery. Individual dispensors as well as HMO’s are equally at fault.
    Thank you.

    1. Mae Swanbeck: It is not a matter of being willing to to pay high prices. Most of us are deeply aggravated at the prices. But if we don’t buy hearing aids we become functionally deaf, and there are a lot of miseries that attend that.

  91. Thank you to Ed Belcher for this neat analysis. For patients turning to the Internet for a low-cost hearing loss treatment, this article is undoubtedly comforting. However, controversial source data aside, there is a basic problem with Belcher’s analysis that patients should be aware of in order to make an informed decision.

    Belcher makes an apples-to-oranges comparison when he conflates the merchandising operations of an Apple Store with the operations of an audiology or hearing instrument dispenser’s office. In his figures, Belcher refers to these operations as “Retail.”
    Let’s realistically compare the process of purchasing a hearing aid versus an iPad.
    Anyone who has purchased hearing aids in a clinic understands that a competent provider takes a complete patient history, performs otoscopic and audiometric evaluation, and makes a customized recommendation for a device based on individual loss and lifestyle needs. He or she may then take an ear impression, and on delivery of the devices programs them using a custom prescription and patient feedback during a fitting process. Anyone who has purchased an iPad from an Apple Store knows that the sales associate listens to the customer’s needs, makes a recommendation for a product, and swipes a credit card.
    But the hearing healthcare experience does not stop when the devices are purchased. Competent providers deliver followup care in the weeks immediately following delivery, to adjust fitting on the basis of patients’ real-life experience. They regularly clean and check devices to keep them in good repair and retest patients’ hearing annually to stay abreast of any fitting changes that may be necessary. They counsel patients on the best use of their devices as part of a complete auditory rehabilitative program, including communication strategies and education on taking full advantage of available technology.
    Therefore, to equate the operations of a hearing health clinic and an Apple Store, and refer to both as “retail,” is disingenuous. Belcher’s aim is not to inform patients about the great deals to be had from online hearing retailers. Rather, he hopes to lead patients away from quality, individualized hearing healthcare available from competent providers.

    1. This response is perfect in explanation of a higher cost factor for hearing aids. First you cannot compare the cost of an ipad vs a hearing aid as it technically is not the same product. Although I agree hearing aids can be cost prohibitive for a huge majority of people, it is still a business whereas the hearing health care professional invests his/her time and money.time & time and meny

      1. I agree you can’t compare. the iPad is a thousand times more complicated and use and should cost 100 times the cost of the little piece of plastic and electronics in a hearing aid. Somehow though, they are sold to anyone that walks in the door and ask for one with no training. Slightly demented old people often know how to use hearing aids, but very few of them can operate a modern cell phone or iPad. So much for the too complicated idea! This article and all of them in this publication simply make excuses for the extremely corrupt government protected hearing aid industry. For many years I paid $200 to $300 everytime I broke or lost my prescription glasses. Now I order them in quantiy from China starting at $8 each. At this price, the mfg in China still makes a profit and pays the over the sea shipper. The optometrist industry has obviously shredded, but American people who know how to order them are much wealther from the money they save. In aggregate their savings dwarf the optomerist’s losses. That is what one calls gains from a free market. The elderly people can now afford an alarm system and a new air conditioner, and those industries prosper. The lower price is what a few pieces of plastic and some tiny metal hinges should be worth. They obviously cost almost nothing to make. Mass marketed hearing aids should be no different, not unlike any other little changing electronic devices. For example, they sell computer chips and other devices at comptuer stores with capacities, say 64 gigabytes, that cost millions of dollars 40 years ago that they now cost 10 dollars and that they often give a way for free on promotions. If it was not for the crony capitalist corruption and protection from government regulators hearing aids would have had a similar price drop. Oh, and where do I get my prescription? Wall Mart will do it for you on a walk in basis for just a few bucks, likely around $35, and not try to hard sell you any $200 dollar glasses while you are there or care if you buy any. And by the way, did you ever wonder why when you buy some glasses in some mall glass/optomerist shop that you have to wait about 10 days to have them “made”? Well when I started buying glasses from China, I noticed that was the same amount of time my glasses took to arrive in the mail from China. 10 days. Got it? Your friendly neighborhood optomerist has just been odering them from China, too, and trying to keep the hearing aid business model alive at your expense by sticking you with a huge markup.

    2. At $100 per hour for fitting and training for a total of 4 hours for a pair or a total of $400 for the expertise of the provider seems to a very reasonable pay scale.if your suggesting that some how the price for the person doing the fitting adjusting and so on is worth, upwards of $300 to $400 per hour I’m at a loss. Adding $800 to $1200 or more for this service. Smacks of just outright greed, directed at folks for the most part are on fixed incomes. The to top that off the replacement of the product in 3 to 5 years with the costs rising each time is rediculus. I have noticed in my area that those who sell the hearing aids take out full page ads on a regular basis, along with direct marketing, with deals for dinners and othe come on’s. There must be tremendous profit per unit to allow for all the marketing. Fair pricing for goods and services provided should support a good living and a lot of return business. But the desire to have the most money or things is what seems to drive most sellers, 3X the wholesale cost indeed.

      1. I agree with what you say. Even,taking into cost checking and cleaning your Hearing Aid every 3 months during the warranty process does not justify the $3000 cost.

  92. Really interesting.

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