Will Apple Make an OTC Hearing Aid?

Opinion: Stated or unstated, they’ll be there every step of the way.

An article in the December 9, 2022 Business Insider about Apple needing to comply with the European Union’s USB-C port specifications may contain a juicy insight about how the company perceives its AirPods Pro true wireless earbuds. While in the past the company has been careful not to position AirPods Pro as having hearing aid-like functionality, Apple Senior VP of Worldwide Marketing Greg Joswiak indicated that the company is well aware of their hearing-enhancement potential.

Apple Airpods Pro 2 1200x675

Apple AirPods Pro 2.

Joswiak made the admission at a WSJ conference while commenting about Apple’s unique ability to engineer creative workarounds to government regulation. Joswiak said he "doesn't mind governments telling us what they want to accomplish" for compliance to the USB-C port specs, but also noted that Apple's engineers are "pretty smart." For example, he said, Apple's engineers made "an industry standard" hearing aid for iPhones after the US government made a hearing aid compatibility regulation that he said didn't work.

It’s probably an offhand remark, but it certainly implies the company believes Apple AirPods Pro is a remarkable hearing device, at least when paired via MFi to its flagship product, the iPhone.

And they're not wrong. Apple’s Airpods Pro 2 (and 1) can hold their ground against most hearing enhancement devices intended for situational use. While HearingTracker has pointed out in articles and videos (see below) that the AirPods Pro use time—a key factor in all-day-wear hearing aids—is far too short, they are easy to set up and use as hearing aids. And for those with milder forms of hearing loss, they provide a decent amount of benefit.

In this video, HearingTracker Audiologist Matthew Allsop explains how to set up your Apple Airpods Pro as hearing aids. Closed captions are available on this video. If you are using a mobile phone, please enable captions clicking on the gear icon.

Evidence Mounts for the use of AirPods Pro as an OTC Hearing Aid

In December 2021, a study from the National Acoustic Laboratories (NAL) in Australia, a world-class center for hearing-related research, found the Apple AirPods Pro’s Headphone Accommodations feature provides amplification that helps people with mild-to-moderate hearing loss—the target audience for OTC hearing aids—hear sounds more easily. In May, this same research group also showed the Conversation Boost and Ambient Noise Reduction features of AirPods Pro improved hearing in background noise by about 7 decibels (i.e., a large benefit) when measuring speech in front of a listener in noisy environments like those found in bars or restaurants. The researchers concluded, “With these hearing aid-like features, AirPods Pro have the potential to help some people with hearing loss understand and communicate during conversations.”

And in November, an article in iScience showed that AirPods Pro were comparable to hearing aids in making speech clear in background noise. The Taiwan-based researchers presented listeners with speech in a variety of noisy settings and found the softest levels at which listeners could accurately identify a series of Mandarin sentences. While premium hearing aids provided an edge on “basic” hearing aids or AirPods Pro, the AirPods Pro were found to be as effective as basic hearing aids.

The OTC hearing aid market is just getting started

If Apple is interested in entering the OTC hearing aid market, it’s not alone. In the past year, several tech giants have thrown their hat into the OTC ring, including Sony, HP, Jabra, and Bose, and more will come.

Hearing Aid Mkt Pentration By Hl Severity

According to the National Institutes of Health, there were some 29 million people who could have benefitted from hearing aids in 2015. In general terms, the above graphic illustrates that hearing aid market penetration rates increase with the severity of hearing problems, ranging from mild to severe/profound hearing loss. OTC hearing aids are designed for those with mild-to-moderate hearing loss—the larger unserved population who could benefit from amplification (shown in gray at the bottom two-thirds of the pyramid)—as well as those who fall outside this diagram, a large number of people who do not have an “audiometric hearing loss” but could still benefit from situational help in places like noisy restaurants and bars. Source: Niels Granholm-Leth of Carnegie Investment Bank, WHO, Sonova

The market is quite large. Beck and colleagues state that about 38 million people in the United States have hearing loss, and another 26 million have near-normal audiometric hearing but still complain of hearing difficulties, particularly in noise. Qualcomm, in its 2022 State of Sound Report—a summary of data from thousands of audio consumers around the world—revealed that 25% view "hearing assistance/enhancement" as a purchase driver, 16% use true wireless earbuds to improve hearing in noisy places, and earbud users spend 1.4 hours/day wearing their devices for hearing-in-noise improvement.

Why might Apple be reluctant to jump into the OTC hearing aid market?

Numerous observers have conjectured about Apple entering the OTC hearing aid market, especially after the FDA’s rules for the new class of hearing aids were finalized in August and took effect in mid-October. For their part, Apple has remained tight-lipped about the AirPods Pro performance as an OTC hearing aid.

It's unclear what regulatory hurdles Apple would need to jump over, but as Joswiak states, Apple's engineers are "pretty smart." From a technical standpoint, it would appear to be relatively easy for Apple to create a product or app function that complies with the FDA’s technical specifications for OTC hearing aids involving things like output limits, latency, etc.

The FDA’s new OTC hearing aid rules entail a laundry-list of technical specifications, but represent a relatively low bar meant only to ensure minimal standards of performance. Still, there could be inherent technical restrictions that make it unwise or otherwise unsavory from an audio-engineering and marketing standpoint to bend Airpods into a hearing aid.

Do you want to make compromises in the product? If Apple has proven anything with the success of Airpods, it is that sound quality reigns supreme. The entry and subsequent withdrawal of Bose from the OTC hearing aid market might be instructive. Although the Bose SoundControl hearing aid was launched in August 2021 for $850 per pair and boasted an innovative and effective fitting and amplification system, it did not achieve the popularity the company had hoped, possibly due to two missing features: Bluetooth audio streaming and rechargeability. These were left out to conserve the battery life needed for 16+ hours of operation each day, a critical requirement of traditional hearing aids. For this same reason, Bose also made some compromises in sound quality when compared to its other products. SoundControl ultimately became a victim of the company's strategy pivot in May 2022 when it ceased hearing aid manufacturing to refocus on its core audio lines. Their innovative technology has since been incorporated by Lexie (Hearx) in its ‘Lexie Powered by Bose’ hearing aids.

Hearing is hard. This brings up yet another obstacle: no company has yet to achieve a leadership foothold in the direct-to-consumer or nascent OTC hearing aid market—even given some excellent products with strong branding behind them. Getting people to listen to music is a lot easier than getting them to address their hearing problems. The withdrawal of Bose from hearing healthcare was preceded by names that include Bausch & Lomb and RCA Labs (Songbird Medical), and more recently Doppler Labs. Additionally, although Apple’s innovations border on legendary, the company is not best known as a first-mover, but rather as a “game-changer” in entering established markets.

A changing market. Finally, just like hearables, traditional hearing aids are rapidly becoming multifaceted. In today’s hearing aids, Bluetooth streaming for audio and phone calls is now a standard feature (with Auracast on the horizon), about two-thirds of all hearing aids sold are rechargeable, and an increasing number employ motion and biometric sensors in combination with AI or machine learning—all in an extremely tiny package that sits behind or inside your ear. Step counters, fitness trackers, heart rate monitors, fall detection alerts, tinnitus maskers, and language translators are also some features now available. So, are hearing aids turning into healthables, will hearables increasingly incorporate hearing-aid-like features, or will new platforms emerge that help unify hearables, healthables, and hearing aids?

Audiologist Matthew Allsop looks at 5 things that most people don't know hearing aids can do. Closed captions are available on this video. If you are using a mobile phone, please enable captions clicking on the gear icon.

The answer, of course, is yes. In May 2021, I asked Starkey Hearing Technologies Founder Bill Austin—an industry veteran who has had a front-row seat to the hearing healthcare market for the last 60+ years—where he thought hearing aids are going. “If you’re talking about what we call today the ‘hearing aid,’ then there isn’t a future; the future is in new devices,” he replied. “Certainly, it’s about devices that will compensate for the damaged auditory system, but hearing aids will also help people overcome many other challenges in life so they can do more and be more.”

Last year, Apple made it clear they are interested in "working to change how people think about, talk about, monitor, and focus on their health." Increasingly, better hearing is being linked to reduced risk for chronic illness, and has been cited as the single-largest modifiable risk factor against dementia.

So, will Apple make an OTC hearing aid?

The hearing healthcare market is currently a moving target that will continue to gyrate to a disruptive beat. For now, Apple won’t officially say if they’re interested in making an OTC hearing aid. But offhand remark or not, the senior vice president of worldwide marketing seems to indicate that he thinks they’ve already got one, and he's not wrong.

There will be a continued migration of amplification and speech enhancement features into mainstream audio devices—along with a continued migration of lifestyle and healthable features into hearing aids—to benefit people with both normal and near-normal hearing, as well as for those with hearing impairment. Given this and the size of the market, it’s almost guaranteed Apple will be there—stated or unstated—every step of the way.