Top-10 Hearing Healthcare Stories and Trends in 2024-25

While a lot happened in 2024, here is a highly subjective list of the top 10 trends and storylines concerning hearing aids and hearing healthcare, along with some speculation about what we’ll see in 2025 and beyond. I’ll quickly note that I could have added many other events and topics to this list, including changes in Medicare reimbursement, the evolving Medicare Advantage plan landscape, continued retail consolidation, the shortage of hearing care providers, cool new products, and more. Also note our recently published article by Bridget Dobyan and Tom Powers, “Trends in U.S. Hearing Aid Coverage and Access: From Medicare to OTC and AirPods.”

I’d be interested to know what you'd include on your top-10 list (you can comment on the LinkedIn page for this article).

1) Prescription Hearing Aid Sales Finally Stabilize, Unless…

While I no longer have access to Hearing Industry Association (HIA) statistics, sources tell me that the 2024 US commercial hearing aid market grew in net unit volume by slightly more than 5% while VA dispensing activity grew by about 1%. This would imply the industry experienced a net unit gain of about 4% and has finally stabilized, returning to its historical norms of around 3-6% annual increases.

Hearing aid sales have experienced seesaw fluctuations since the pandemic. In 2020, COVID-19 brought hearing aid sales to a near standstill in the second quarter, causing unit sales to plummet by 18% that year. Sales rebounded in 2021 by an astonishingly strong 36%, flattened in 2022 (1% growth), then increased substantially more than expected (7%) in 2023. In 2024, hearing aid sales are finding their level again with what is probably around 4% for the entire market (5% for commercial sales and 1% for the VA which constitutes about one-fifth of all US devices dispensed).

Coming in 2025: More stability and more normal growth of 3-6% (i.e., similar to 2024, which was toward the lower end), unless…the Trump administration follows through with its promised tariffs on China of up to 60% and smaller amounts (10-20%) on other countries. With the largest hearing aid companies’ headquarters and manufacturing being located overseas and in Mexico, the industry could be significantly impacted by a trade war. If tariffs are applied, substantial price increases could follow, depending on what countries the tariffs are levied against. Although tariffs would, in all likelihood, affect all companies that outsource (at least some) parts from the levied countries, WS Audiology and GN are probably most exposed due to having substantial manufacturing in China. US-based Starkey is the least affected, with the others falling somewhere in between.

While things could get messy, particularly for companies relying on China for manufacturing, my magic 8-ball thinks the incoming administration will back off from a major trade war. Companies have also been preparing for the potential tariffs for some time now, so that may also help mitigate things.

2) Apple Introduces Hearing Features Software in AirPods Pro 2 Update

It was funny when, on April 1, our friend Dr. Cliff made an April Fool’s video proclaiming that Apple was introducing a hearing aid. However, fiction became reality on September 10 when Apple announced its Apple Hearing Features—including a Hearing Aid Mode for AirPods Pro 2. I’d been writing about how Apple already had an OTC hearing aid as far back as January 2023 and again in March 2024, so it wasn't exactly a surprise.

What’s important to note, however, is that Apple didn’t make a new hearing aid. Instead, it gained approval on software for a hearable, essentially transforming AirPods Pro 2 into OTC hearing aids. Why is this distinction so important? Because it means all of Apple’s major competitors that make high-quality hearables with similar personalization features (i.e., transparency modes with compensation for unique hearing loss profiles) may follow Apple’s lead. This could include some of the world’s largest consumer audio manufacturers, including Samsung, Sony, Beats, Bose, Google, and more.

While the mainstream media focused primarily on how this would be the ruin of prescriptive hearing aids (it wasn’t and won’t be), if you ask me, the real story is what this portends for OTC hearing aids…

3) The Rocky OTC Hearing Aid Market Gets Rockier

Apple’s news shouldn’t be a death knell for the OTC market any more than Costco was for prescriptive aids. But AirPods Pro 2 will establish a new baseline, or anchor price—around $250—for what consumers should pay for decent lower-cost OTC hearing aids. For prescriptive hearing aids, Costco effectively sets the low entry-level price at $1,500, for which you can get a good hearing aid, but probably not with a full-service provider backing it up with personalized care and multiple visits, solutions for complex listening situations, tinnitus remediation, accessories, etc. This $1,500 mark also effectively sets the highest price for OTC hearing aids.

I don't think anyone, including the major suppliers of mics and receivers, really knows how many OTC hearing aid units are sold in the United States or what the return rates are. Best guesses range from about a half million to over 1 million units, with return rates ranging from 25% to 50%. Prices for established OTC hearing aids generally decreased in 2024, and most new product introductions—like Eargo Link, Jabra Select 50R, JVC, and Sony CRE-C20—were priced near or under $1000. Two eye-opening exits from the OTC hearing aid market were Nuheara/HP Pro and Jabra Enhance Plus. I have tried both, and they were very good devices—proving again that hearing is hard.

I think Apple’s Hearing Aid Mode is a good thing for the OTC hearing aid market for the same reason I think Costco is a good thing for the prescription-fit market. Although they’re certainly not for everyone, both provide large numbers of consumers with quality amplification while improving choice, accessibility, and affordability. Apple’s Hearing Aid Mode has some significant downsides: a short battery life of 5-6 hours and only middling performance in noise. Our HearAdvisor lab places Apple AirPods Pro 2 at #17 on its Leaderboard among the OTC hearing aids tested, although it’s #2 in the sub-$500 price range (Elehear Beyond is #1 at $399).

Ultimately, the new ability to use AirPods Pro 2 as an OTC hearing aid should, in theory, allow most people who have milder hearing loss to try out “pretty good” amplification for around $200 to $250. Nervous should be those OTC hearing aid companies that offer worse-performing devices that cost more and don’t have as many perks or telecare. There are many.

Coming in 2025: At present, it looks like OTC hearing aids are an additive factor for, and are not cannibalizing, prescriptive hearing aid sales. Even without Apple, OTC hearing aids have increased the public's knowledge about the importance of hearing healthcare. These two distinct markets, with overlapping but different user bases, should both do well in the future.

It's ironic that OTC hearing aids were created, at least in part, to disrupt the hearing industry, but a lot of the change and disruption is actually occurring in the OTC market, which in fairness is only 2 years old.

In 2025, a new form factor should debut on the US market: Nuance Audio Glasses promises to be a new, effective, and “invisible in plain sight” option for OTC hearing aids, possibly becoming available in the U.S. during the first half of 2025 (pending FDA approval). A product of Essilor-Luxottica— the world’s largest eyeglass maker with some 18,000 stores globally—a Nuance Audio Glasses prototype received rave reviews from several industry experts who tried its open-ear amplification system.

4) Advanced AI in Hearing Aids Redefine “High-Performance Hearing Aids”

A quick glance back at hearing aid history: In December 1996, Sergei Kochkin published a MarkeTrak article that used customer satisfaction ratings to gauge the success of 13 single- versus multi-channel “high-performance hearing aids” on 30 different consumer metrics. Astute readers quickly noted that one mysterious hearing aid ran the table in customer satisfaction. The number of channels or programmable memories didn’t have much to do with it; it turned out that the clear winner employed a directional microphone system (Phonak’s AudioZoom). Advanced directional mics quickly became standard in any high-performance hearing aid large enough to accommodate them.

Flash forward almost 30 years, and hearing aids featuring artificial intelligence (AI) appear to be winning the day in the HearAdvisor lab's test ratings. Currently, the highest scores for hearing in noise—the brass ring for hearing aid performance—are AI-driven devices from Phonak, Oticon, and Starkey that employ Deep Neural Networks (DNN). Admittedly, this is a relatively small data set of products at this point, and there are many more product attributes to consider than just hearing in noise. But it’s at least interesting that the current 5-top hearing aids HearAdvisor's prescription hearing aid leaderboard feature DNN. I should note that all “Big 5” global hearing aid companies employ some form of machine-learning or AI functions for sound-scene identification, processing algorithms, user adjustments, etc.

In 2024, Phonak launched its Infinio and Sphere Infinio hearing aids at a July media event in New York City and a week later in the Las Vegas Sphere—in what was probably the most elaborate product introduction in industry history (the photo at the top of this page is of Phonak's Jason Mayer and Christine Jones debuting Infinio inside the Sphere). Starkey, which has had AI-driven hearing aids since its Livio platform in 2018, launched its latest Edge AI hearing aid in Minneapolis in October.

AI-driven hearing aid technology and AI-assisted programming will redefine hearing aid performance. We're just scratching the surface of this technology in hearing healthcare. You can expect much more, from changes in how hearing aids are programmed to healthcare monitoring and notification features.

Coming in 2025: By the end of the coming year, we’ll see almost all major hearing aid manufacturers offer AI-driven hearing aid technologies that substantially improve hearing in both quiet and noise.

Also of note… At the risk of blatant self-promotion, HearAdvisor testing and HearingTracker reviews and product comparisons, as well as the Hearing Aid Forum, have emerged in 2024 as important resources for consumers who are looking for good information about hearing solutions. The industry needed some objective apples-to-apples measurement of hearing devices. HearAdvisor has now tested about 80 prescription and OTC hearing aids (it found close to 15 hearing aids that offer little or no improvement for speech understanding in quiet or noise—with some making listening worse!). The HearingTracker website will have been visited by 2.3 million consumers this year, and our YouTube channel with Audiologists Matthew Allsop and Steve Taddei has garnered about 2.7 million views.

5) ACHIEVE Study and Research Involving Hearing Aids and Cognition

The highly anticipated and landmark ACHIEVE study, the first large-scale, randomized longitudinal research on the impact of hearing aids and hearing intervention on cognitive decline, was published in the September 2, 2023 edition of The Lancet. The study results showed that hearing care intervention almost halved (48%) the cognitive change of one group of participants who were generally older and had more risk factors (including cardiovascular problems) over the relatively short 3-year study period. However, another healthier group of study volunteers experienced no benefit in terms of reducing cognitive decline, but did experience significant benefit in other areas.

Although this study was published over a year ago, its full impact—along with a steady trickle of other interesting findings on the links between hearing loss, cognitive status, and dementia—was mainly felt in 2024. Several more studies on hearing loss and cognitive status have been published since then, and here are just a dozen interesting publications on the subject that HearingTracker has cited in the Research section of its Audiologist Informer weekly enewsletter:

• Hearing Loss, Hearing Aid Use, and Risk of Dementia in Older Adults
• Auditory, Visual, and Cognitive Abilities in Normal-Hearing Adults, Hearing Aid Users, and Cochlear Implant Users
• Hearing Loss and Associated 7-Year Cognitive Outcomes Among Hispanic and Latino Adults
• Interactive effects of hearing aid use and cognitive function in patients with hearing loss
• Midlife Speech Perception Deficits: Impact of Extended High-Frequency Hearing, Peripheral Neural Function, and Cognitive Abilities
• Auditory encoding of natural speech at subcortical and cortical levels is not indicative of cognitive decline
• Auditory Processing but Not Peripheral Hearing Differs Between Older Adults With and Without Mild Cognitive Impairment
• Peripheral hearing loss at age 70 predicts brain atrophy and associated cognitive change
• Impact of dual sensory impairment on the risk of incident dementia: A protocol for a systematic review and meta-analysis
• Age-Related Hearing Loss, Cognitive Decline, and Social Interaction: Testing a Framework
• The prevalence of patient-reported cognitive complaints and dementia risk factors in the audiology clinic
• Cross-Sectional Associations of Peripheral Hearing, Brain Imaging, and Cognitive Performance With Speech-in-Noise Performance: The ACHIEVE Brain Magnetic Resonance Imaging Ancillary Study

You get the idea: there is a lot of research is being conducted on this topic and a tremendous amount to keep up with. GN has recently launched a Masterclass series on the topic that does a good job of summarizing what we know. In coordination with Phonak, HearingTracker also facilitated a discussion with researchers from the ACHIEVE and ENHANCE studies (see video below).

Coming in 2025: A backlash may be imminent because—despite all of the above— the science still isn’t all there about hearing aids and their ability to directly affect dementia. As Piers Dawes & Kevin Munro, Barbara Weinstein & Jan Blustein, and several others have pointed out, the professional community has an obligation to be careful with all this new data.

In November, the UK’s major professional organizations issued a strongly worded guidance document on the link between adult-onset hearing loss and dementia. Hearing aids have been scientifically proven to improve communicative function and lessen cognitive load (i.e., lighten the load on brain functions), but the science doesn’t support saying that untreated hearing loss on its own can cause dementia.

6) A Golden Age of Hearing Aid Media Coverage

Along with all the media coverage surrounding hearing loss and dementia, we had Gerry Turner, the dashing 71-year-old hearing aid-wearing Golden Bachelor. While it may be easy to laugh off or dismiss this kind of media attention, it’s exactly the type of exposure hearing healthcare needs to break down the stigma of using hearing devices. As Shari Eberts noted, the Golden Bachelor positioned hearing aids as not just devices for improving communication, but also for making people sexier.

Also making headlines were Huey Lewis and Paul Simon, two musicians who received a lot of press detailing their struggles with Meniere’s Disease and hearing loss, respectively. Starkey recently signed on Alice Cooper as an ambassador for their brand, and he promptly entertained with some great stories in a Starkey Sound Bite episode with David Fabry.

7) Interstate Compact for Audiologists

The Audiology & Speech-Language Pathology Interstate Compact (ASLP-IC) is a legal agreement between states that allows licensed audiologists and SLPs in good standing to gain the privilege to practice across state lines in other ASLP-IC member states.

According to the ASLP-IC Commission page, the intended benefits include:

• Improved continuity of care and consumer protection across state lines
• Improved portability for military spouses, students, and traveling patients
• Improved access and choice to audiology providers
• Facilitates alternate delivery methods (telehealth)
• Simplifies/accelerates the current process
• Addresses portability & barriers to access
• Practice of audiology occurs in the state where the patient/client is located at the time of the appointment
• Ensures participating audiologists have met acceptable standards of practice

In some ways, the ASLP-IC may “democratize” hearing care and teleaudiology. No more will licensing boards with disparate rules, fees, and regulations pose barriers to helping cross-border patients. With the ASLP-IC, it’s also possible that enterprising independent audiologists and practice groups with the right resources might expand their marketing territories and serve more patients, particularly through telecare. The flip side of that, of course, is that the Compact may create more competition for smaller practices and hearing aid specialists.

At this writing, 34 states are taking part in the Compact: Alabama, Alaska, Arkansas, Colorado, Delaware, Florida, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Minnesota, Mississippi, Missouri, Montana, Nebraska, New Hampshire, North Carolina, Ohio, Oklahoma, Rhode Island, South Carolina, Tennessee, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin, and Wyoming. According to a map from the organization, New Jersey and Nevada have legislation pending.

Coming in 2025: This year should see the culmination of the Compact and a lot of hard work by the audiologists who spearheaded the effort. There is more work to do, but it’s anticipated that the first Compact privileges will be issued in late-summer 2025.

8) Two Giants in Audiology Pass

There was probably no one more knowledgeable about the history and research of audiology or more generous with his time than Dr. James Jerger, the founding father of the American Academy of Audiology (AAA). He passed away in July at the age of 96.

Another huge figure in the field and pioneer of auditory neuropathy research, Dr. Charles Berlin, died in August at age 90. I’m sure other great hearing care researchers and clinicians also passed away. However, even given their long lives and many contributions, the deaths of these two audiology research legends, authors, and mentors within a month of each other was jarring.

9) ReSound Spurs on LE Audio and Auracast-ready Revolution

After ReSound announced in September 2023 that its new Nexia hearing aids offer LE Audio and Auracast broadcast technology, every hearing aid launch by a global "Big 5" hearing aid manufacturer in 2024 featured "Auracast-ready" devices, pending a firmware update. The promise of Auracast has probably been beaten to death, but it really is a revolutionary step forward for accessibility in all audio devices, especially for hearing aids.

AuraFuturity Founder Andy Bellavia recently wrote about his experience listening to a Richard Einhorn concert at Lincoln Center in New York using Auracast via Nexia hearing aids. Additionally, Audeara showcased its Audeara Buds at what was described as the “world’s first Auracast-enabled pub” in Brisbane, Australia.

Coming in 2025: We expect several new major hearing aid launches in the coming year, including new products from ReSound and possibly Oticon, and it would be surprising if these did not offer LE Audio and Auracast. Additionally, we will see more Auracast transmitters and receivers making their way into some venues and audio devices.

10) $6 Billion Lawsuit Involving Military Earplugs Settled by 3M

It is thought to be the largest mass tort in the nation's history. In late-January 2024, 3M announced it had exceeded the participation threshold for a settlement agreement in which the company would pay $6 billon to more than 250,000 eligible claimants whose hearing had been damaged by its Combat Arms earplugs. The military purchased the earplugs between 1999 and 2015, and the earpugs were originally developed by Aearo Technologies, which 3M purchased in 2008. Payments are scheduled to go into 2029.