1. European Hearing Instrument Manufacturers Association What can we learn from 10.586 hearing impaired people? Stockholm, April 3, 2014 1

2. European Hearing Instrument Manufacturers Association Country20092012Sponsor GermanyEHIMA FranceEHIMA UKEHIMA SwitzerlandHSM NorwayHM Association ItalyANIFA JapanJHIMA DenmarkLFH Euro EuroTrak/ JapanTrak were developed and executed by Anovum, Zürich © Anovum 2012 - EuroTrak 2012 JHIMA EHIMA Local HM Association HSM ANIFA LFH

3. European Hearing Instrument Manufacturers Association Short interviewsLong interviews RepresentativeHA ownersHA non-owners UK14896501795 Germany (GER)13922500864 France (FRA)15430502809 Norway (NOR)14866691618 Switzerland (CH)14836514813 Italy (ITA)15536510801 Denmark (DEN)14070656664 JapanTrak (JAP)15036450898 Total 118‘592 43246262 3 JHIMA EHIMA Local HM Association HSM ANIFA LFH

4. European Hearing Instrument Manufacturers Association % self-reported hearing impaired (Base: population) Differences may be caused by: Age-gender-structure (=age pyramid) Awareness: Hearing tests, health care systems etc. Prevention / Work situation Other factors Source: EuroTrak /JapanTrak 4

5. European Hearing Instrument Manufacturers Association “older” populations: Source: EuroTrak /JapanTrak 5

6. European Hearing Instrument Manufacturers Association Adoption: Proportion of people with hearing aid (% of population) and adoption rate (% of stated impaired) Source: EuroTrak /JapanTrak Differences may be caused by: Health care system Reimbursement system / income structure Market development Culture Other factors. 6

7. European Hearing Instrument Manufacturers Association Source: EuroTrak /JapanTrak Differences may be caused by: Health care system Reimbursement system / income structure Market development Professional “attitude” % Binaural fitting 7

8. European Hearing Instrument Manufacturers Association Do you have tinnitus (ringing or other noises in the ears or head) in one or both ears ? Source: EuroTrak /JapanTrak 8

9. European Hearing Instrument Manufacturers Association permanently Tinnitus sometimes Tinnitus Source: EuroTrak /JapanTrak Differences may be caused by: Health care system / income structure Culture etc. Have you ever thought about a treatment of your tinnitus? 9

10. European Hearing Instrument Manufacturers Association Do you have tinnitus (ringing or other noises in the ears or head) in one or both ears ? Have you ever thought about a treatment of your tinnitus? permanently Tinnitus sometimes Tinnitus Base: 3‘956 Pa ge 10 © Anovum 2012 - EuroTrak 2012

11. European Hearing Instrument Manufacturers Association Pa ge 11 Do you have tinnitus (ringing or other noises in the ears or head) in one or both ears ? Have you ever thought about a treatment of your tinnitus? permanently Tinnitus sometimes Tinnitus Base: 3‘981 © Anovum 2012 - EuroTrak Germany 2012

12. European Hearing Instrument Manufacturers Association Base: n=1‘320 Page 12 © Anovum 2012 - EuroTrak 2012

13. European Hearing Instrument Manufacturers Association Base: n=1‘309 Page 13 © Anovum 2012 - EuroTrak 2012

14. European Hearing Instrument Manufacturers Association Source: EuroTrak /JapanTrak 14

15. European Hearing Instrument Manufacturers Association 15

16. European Hearing Instrument Manufacturers Association How useful are your hearing aids on your job? N: UK 144/FRA 204/ GER 209 Source: EuroTrak /JapanTrak 16

17. European Hearing Instrument Manufacturers Association Source: EuroTrak /JapanTrak 17

18. European Hearing Instrument Manufacturers Association Depression symptoms: PHQ-2 Screening: In the last 2 weeks: Little interest or pleasure Feeling down, depressed, hopeless Source: EuroTrak /JapanTrak 18 % of people with depression symptoms

19. European Hearing Instrument Manufacturers Association Base: Hearing aid owners and non owners with top 50% hearing loss Dementia symptom: Getting more forgetful in the last year? Source: EuroTrak /JapanTrak 19 % of people getting more forgetful

20. European Hearing Instrument Manufacturers Association Depression symptoms: PHQ-2 Screening: In the last 2 weeks: Little interest or pleasure Feeling down, depressed, hopeless Dementia symptom: Getting more forgetful in the last year? Base: hearing aid n=548 / no hearing aid =144 Pa ge 20 © Anovum 2012 - EuroTrak 2012

21. European Hearing Instrument Manufacturers Association Depression symptoms: PHQ-2 Screening: In the last 2 weeks: Little interest or pleasure Feeling down, depressed, hopeless Dementia symptom: Getting more forgetful in the last year? Base: hearing aid n=454 / no hearing aid =98 Pa ge 21 © Anovum 2012 - EuroTrak 2012 Probability of depressive disorder %

22. European Hearing Instrument Manufacturers Association Source: CH-Blick; 13.4.2012 Mentally and physically exhausted people …. cost CHF 4.2 billions/year in Switzerland Source: EuroTrak /JapanTrak 22

23. European Hearing Instrument Manufacturers Association Base : Top 50% n=141 / hearing aid n=391 In the evenings I often feel physically exhausted In the evenings I often feel mentally exhausted Pa ge 23 © Anovum 2012 - EuroTrak 2012

24. European Hearing Instrument Manufacturers Association Base : Top 50% n=186 / hearing aid n=669 In the evenings I often feel physically exhausted In the evenings I often feel mentally exhausted Pa ge 24 © Anovum 2012 - EuroTrak 2012

25. European Hearing Instrument Manufacturers Association  Hearing aids are a sound investment – not only for individuals, but for society as a whole 25

26. European Hearing Instrument Manufacturers Association -and reasons not to use them 26

27. European Hearing Instrument Manufacturers Association Source: EuroTrak /JapanTrak % Overall satisfaction with HA 27 % satisfied 84% 80% 77% 72% 70% 36% !

28. European Hearing Instrument Manufacturers Association % Satisfied 70% 75% 65% 64% 77% 66% 36% 79% 82% 68% 75% Pa ge 28 © Anovum 2012 - EuroTrak 2012

29. European Hearing Instrument Manufacturers Association % Satisfied 72% 78% 63% 69% 79% 68% 51% 77% 84% Pa ge 29 © Anovum 2012 - EuroTrak 2012

30. European Hearing Instrument Manufacturers Association HA-owner, n=656 Dispenser Sound quality signal process. Product features Listening situation %dissatisfied= % very dissatisfied + % dissatisfied + % somewhat dissatisfied %satisfied= % somewhat satisfied + % satisfied + % very satisfied Pa ge 30 © Anovum 2012 - EuroTrak 2012

31. European Hearing Instrument Manufacturers Association HA-owner, n=691 Dispenser Sound quality signal process. Product features Listening situation %dissatisfied= % very dissatisfied + % dissatisfied + % somewhat dissatisfied %satisfied= % somewhat satisfied + % satisfied + % very satisfied Pa ge 31 © Anovum 2012 - EuroTrak 2012

32. European Hearing Instrument Manufacturers Association Base: non owners Top 50% HL: n=145 Pa ge 32 © Anovum 2012 - EuroTrak 2012

33. European Hearing Instrument Manufacturers Association Base: non owners Top 50% HL: n=190 Pa ge 33 © Anovum 2012 - EuroTrak 2012

34. European Hearing Instrument Manufacturers Association Owners who don‘t use, n=71 Pa ge 34 © Anovum 2012 - EuroTrak 2012

35. European Hearing Instrument Manufacturers Association Owners who don‘t use, n=71 Pa ge 35 © Anovum 2012 - EuroTrak 2012

36. European Hearing Instrument Manufacturers Association CountryWorn 0 hours/dayWorn 0-1 hours/day JAP12%29% NOR10%24% DEN13%20% UK8%19% SUI4%16% ITA7%15% GER4%13% FRA3%7% © Anovum 2012 - EuroTrak 2012

37. European Hearing Instrument Manufacturers Association CountryDissatisfied %Satisfied % Germany2155 France2866 United Kingdom3152 Italy2361 Switzerland2460 Norway39 !49 ! Denmark2548 ! Japan50 !!!26 !!! 37

38. European Hearing Instrument Manufacturers Association Non-owner: Think about the option to obtain / purchase a hearing aid. What do you think would influence you to obtain / purchase a hearing aid ? Owner: Thinking back to when you obtained your first hearing aid(s), what influenced you to obtain /purchase the hearing aid(s)? Pa ge 38 © Anovum 2012 - EuroTrak 2012

39. European Hearing Instrument Manufacturers Association Non-owner: Think about the option to obtain / purchase a hearing aid. What do you think would influence you to obtain / purchase a hearing aid ? Owner: Thinking back to when you obtained your first hearing aid(s), what influenced you to obtain /purchase the hearing aid(s)? Pa ge 39 © Anovum 2012 - EuroTrak 2012

40. European Hearing Instrument Manufacturers Association HA-owner, n=656HA-non-owners, n=664 Owners: Was any part or all of your hearing aid(s) paid for by a third party ? (Insurance, Government, …) Non-owners: Based on your current knowledge, would any part or all of your hearing aid(s) be paid for by a third party? (Insurance, Government, …) Pa ge 40 © Anovum 2012 - EuroTrak 2012

41. European Hearing Instrument Manufacturers Association HA-owner, n=691HA-non-owners, n=618 Owners: Was any part or all of your hearing aid(s) paid for by a third party ? (Insurance, Government, …) Non-owners: Based on your current knowledge, would any part or all of your hearing aid(s) be paid for by a third party? (Insurance, Government, …) Pa ge 41 © Anovum 2012 - EuroTrak 2012

42. European Hearing Instrument Manufacturers Association  Listening in noise is the main cause for dissatisfaction  Listening in noise is a main cause for not getting hearing aids  Listening in noise is a main cause for not using their hearing aids 42

43. European Hearing Instrument Manufacturers Association  Overall satisfaction is at 70 – 84% forget Japan  Newer hearing aids are doing a better job  Satisfaction goes up with longer use hours  Hearing aids are useful on the job  HA users are less exhausted, physically and mentally, at the end of the day = less risk of burn-outs 43

44. European Hearing Instrument Manufacturers Association  We need to educate ENT doctors better  We need to inform the hearing impaired better about reimbursement possibilities  We should advocate adult screening programs  We should ”educate” politicians about the social cost issues (labor market, burn-outs, depression, dementia,)  Channel more info to tinnitus patients re treatment options? 44

45. European Hearing Instrument Manufacturers Association  Norway, Denmark and UK have a government system with ”free” hearing aids  This contributes to high HA penetration  But not necessarily higher user satisfaction 45

46. European Hearing Instrument Manufacturers Association 46 …and Sweden?

47. European Hearing Instrument Manufacturers Association EHIMA Soeren Hougaard EHIMA secretary general Phone: (+45) 4045 7135 Email: sh@ehima.com 47 sh@ehima.com

48. European Hearing Instrument Manufacturers Association 48