An Industry Renewed After robust annual private-sector growth during 2015-2016 of 8–11%, the first three quarters of 2017 declined to 2–4% annually. Fourth quarter 2017 growth, however, was 7.3% and Q1 2018, 7.2%. Revenues from veteran sales were flat at -0.5%. During 2016, 3.28 million to 3.65 million hearing aids were sold in the US. Of these, 22% were sold through the Veterans Administration’s hearing aid program and 78% were sold in the private market. Six hearing aid manufacturers accounted for 98% of the world market during 2016 and 80% to 90% of the US market. They are GN ReSound, Sivantos, William Demant, Sonova, Starkey and Widex.

Hearing Aid Centers’ Revenue Results During 2017, 33% of the smallest hearing aid dispensing offices (revenue of >$100,000) increased revenue compared to 2016, 33% were flat and 33% had a YOY decrease. Companies earning from $751,000 to $1 million performed the best, with 67% experiencing revenue increases; 15%, no change; and 8%, a decrease. Almost all (88%) of the companies affiliated with or owned by a corporate chain had increased revenues, however, 12% experienced decreased revenues. Just 30% of not-for-profit dispensers had revenues increases; 29%, decreases; and the remainder, flat.

The Business of Audiologists An October 2016 survey from HearingTracker.com of audiologists found they fit 18 to 21 hearing aids per month, the vast majority, or 69.0%, are RIC (receiver in the canal). The next most popular style was BTE (behind the ear), at 9.7%. Phonak, 75%, and Oticon, 70%, were the most commonly dispensed brands; followed by ReSound, 58%; Starkey, 57%; Widex, 44%; Signia, 38%; and Unitron, 29%. More than half (56%) of audiologists surveyed said competition from big-box retailers and online hearing aid sales negatively impacted their business. More than two-thirds (69%) predicted a negative impact on their practices from OTC hearing aids.

The Spectrum of Hearing Loss According to audiologists, 12.1% of their patients have severe hearing loss; 22.8%, moderate-to- severe; 25.7%, moderate; 28.3%, mild-to-moderate; 8.3%, mild; and 2.8%, slight. Oticon is the brand with the highest patient satisfaction, at 70%; followed by Phonak, 57%; Widex, 50%; Unitron, 42%; ReSound, 41%; Signia, 39%; Starkey, 32%; Lyric, 28%; Sonic, 21%; and Rexton, 18%. According to the National Institute on Deafness and Other Communication Disorders (NIDCD), during 2006, there were 162.7 Americans 20–69 years of age with a hearing aid for every 1,000 adults with moderate-to-severe hearing loss.

Listening for Opportunities The Over-the-Counter Hearing Aid Act of 2016 allows certain hearing aids to be sold over the counter and eliminated the requirement that consumers must receive a medical evaluation before buying OTC hearing aids. Costco’s growth in the hearing aid market is estimated at 8–9% annually. Costco offers significantly lower prices for hearing aids than most other dispensers (32% of the price of independent, unaffiliated dispenser for a premium RIC hearing aid). The number of people with hearing loss is still significantly underserved. As prices decrease from OTC and big-box competitive pressure, hearing aid dispensers have an opportunity to increase their volume of sales through more marketing.

Advertising Strategies Although TV in combination with direct mail are excellent channels to reach older Americans, hearing aid centers that utilize TV advertising should also craft a commercial directed at younger patients, many of whom also experience hearing loss. As hearing aid prices decline and over-the-counter brands increase in popularity, hearing aid centers and other retailers who sell hearing aids will need the reach of TV to target a much larger audience, so they can generate a larger volume of customers spending less. Hearing aid centers may find it beneficial to approach local businesses where their employees are subject to loud noise, such as in a factory, and provide an annual hearing test and a discounted purchase as employee benefits.

New Media Strategies Since a significant number of new patients are customer referrals, aggressively ask customers to opt-in to your email newsletter list, which not only should include important information about hearing loss, but also promote a referral rewards program. Use social media not only to reach older Americans, as many are social media users, but also to share information with younger adults about hearing loss from loud music and other sources and new products with Bluetooth connectivity to mobile phones and devices. Videos can be beneficial promotional tools on your Website and social media platforms, including patient testimonials, how a hearing test is conducted and how test results lead to the recommendation of a specific product.