Bottom Line - OTC aids have hurt the Hearing Aid Industy

testing123,

I think you’ve raised some valid concerns, particularly regarding the importance of proper hearing evaluations and professional fitting. However, I believe some of the statements are opinions rather than established facts.

For example, while premium prescription hearing aids often include advantages such as professional fitting, real-ear measurements, remote support, tinnitus programs, and more sophisticated signal processing, that doesn’t automatically mean a more expensive hearing aid will produce better hearing outcomes for every individual.

You also mentioned that OTC hearing aids reportedly have a 70% return rate. I’ve seen that figure repeated online, but I haven’t found widely accepted research supporting it. If there is a reliable study, I’d genuinely be interested in reading it.

Regarding the comment that “cheap aids lack power or programming range,” I think it’s important to distinguish between inexpensive amplifiers and today’s better OTC hearing aids. Devices such as the Elehear Beyond Pro, Sony CRE-C20, Jabra Enhance Select, and Lexie B2 Plus offer features including:

• Self-fitting algorithms

• Multiple fitting channels

• Bluetooth connectivity

• Noise reduction

• Amplification that is appropriate for many adults with mild to moderate hearing loss

They aren’t designed for severe or profound hearing loss, and the FDA has never marketed them for that purpose.

I also agree that a professional audiogram remains the gold standard for diagnosing hearing loss and fitting hearing aids. However, many modern OTC devices—including the Elehear Beyond Pro—perform in-app hearing assessments that generate personalized fittings. While these aren’t as comprehensive as a diagnostic audiogram combined with real-ear measurements, research has shown that self-fitting hearing aids can provide very good outcomes for many adults with mild to moderate hearing loss.

As for the statement that OTC hearing aids have been “a step back,” that’s certainly one perspective. Another way to look at it is that the FDA created the OTC category because millions of Americans with untreated hearing loss were unable to obtain prescription hearing aids due to cost, access, or both. Expanding access doesn’t replace professional care—it provides another option for people who might otherwise receive no treatment at all.

For context, I currently wear Phonak Audeo Lumity L90 prescription hearing aids, but I also own a pair of Elehear Beyond Pro hearing aids as a backup. In my experience, the Beyond Pro is one of the more capable OTC hearing aids in its price range. It includes self-fitting, multiple listening modes, AI-assisted noise reduction, and adequate amplification for many people with mild to moderate hearing loss. Is it a replacement for professionally fitted prescription hearing aids in complex cases? No. But I also don’t think it’s fair to dismiss it as simply a “cheap” hearing aid. Independent reviews have generally found it to be a strong performer within the OTC market, especially considering its cost.

I think both prescription and OTC hearing aids have an important place. The key is matching the right device to the individual’s hearing loss, needs, and budget rather than assuming one approach is always better than the other.

TJN - your post is well-written and supported in several areas. And you’re right, OTC does meet a need for many who have a moderate hearing loss. Yet we all know the return rate of OTC aids is high, and I’m going to guess the failure rate (aid not working properly) is above average. You’ve done more homework regarding which OTC aids might be keepers versus others that end up in the trash. To be honest, I have no idea how many OTC hearing aid brands are on the market worldwide. Is it fifty, one hundred, more?

Unfortunately, for too long, the hearing aid industry has been unregulated and unloved. Maybe that’s due to the medical profession neglecting HA’s in general, the fact that most people would prefer never to use aids, and the high cost. Yet for those who struggle with a mid-range to profound hearing loss, quality HA’s and CI are a vital necessity.

I think the gray line creeps in when the buying public thinks all aids are the same, along with very little research on the buyer’s part. That, along with many aid buyers believing the person handling the hearing instrument transaction actually knows what they are doing.

If we include Airpods in this figure, I bought and tested at least a half-dozen OTC aids, and kept two. Not including Airpods, I kept one. That doesn’t mean the OTC devices didn’t work properly, or couldn’t have been useful. Some weren’t helpful for my issues (none were really designed for them), but all could potentially have been helpful for somebody else. Others were better than nothing, but not as good (for me) as Airpods or the other ones I ended up keeping. One of the good things about OTC is the possibility of doing that. But that does mean that return rates are going to be artificially high. My personal “return rate” was over 80%, but that’s just what doing one’s homework and making informed buying decisions looks like.

I like that he has his videos professionally closed captioned. I find it quite helpful myself.

You can slow down the play speed to 0.75 on youtube if it helps. I often do this with people who talk too fast. And vice versa when they talk too slow (1.25 speed). Click the settings cog in the video controls and it’s one of the options.

Thanks, I didn’t know that. I’ll definitely try it. Cliff Olson is eager to pack in as much information as possible. Or in my case, impossible.

In this peer-reviewed journal article (see below, published this month, sample size = 774), AuDs conducted a study comparing the effectiveness of over-the-counter (OTC) aids to prescription aids. The results indicated that, for individuals within the fitting range of the OTCs, both types of aids provided comparable outcomes.

I agree that some OTCs are garbage, but I’ve played with the Sony CRE-C20, the Sony CRE-E10 and the Airpods PRO and, I found them effective.

One thing I’ve noticed with OTCs and many of the comments here (as well as other places on the internet) is that users with moderate loss and worse don’t find them helpful . Is it possible that most people who return them are actually outside the fitting range of the OTCs? One of the videos of Matthew (hearingtracker) made a comment how most of the OTCs app don’t usually warn the user if their loss is outside of the fitting range of the device. I’ve seen comments here from users who don’t like OTCs and, when I look at their audiogram, they are far from the OTCs fitting range.

https://www.researchgate.net/publication/407228695_Effectiveness_of_Over-the-Counter_Hearing_Aids_Versus_Professionally_Fitted_Devices_A_Systematic_Review_and_Meta-analysis5

The paper I shared is from a peer-reviewed journal. If 774 individuals participated in the study, what are the odds that all the specialists were unaware of how to program a hearing aid for mild hearing loss? Their statistical analysis can detect outliers .

I’ve been out of town, so this comment is a little late.

After my earlier reply about OTC hearing aids, I decided to see if anyone had compared my prescription Phonak Audeo Lumity L90-RL with my backup pair of Elehear Beyond Pro hearing aids.

The Phonaks were released in August 2022, while the Beyond Pros came out in July 2025, so there’s roughly a three-year difference in technology.

I was surprised to find that the Beyond Pro scored higher than my prescription Phonaks in the HearAdvisor evaluation, particularly for speech understanding in noise. That has also been my personal experience. Like many people with hearing loss, I struggle most in noisy environments. If I know I’m going to a pub, restaurant, or another noisy setting, I usually reach for the Beyond Pros. For me, they perform noticeably better in those situations.

On the other hand, the Phonaks are more comfortable to wear, have much smaller receivers, are physically smaller overall, and provide a better streaming experience. I also think they perform slightly better in quiet listening environments.

Based on my own experience, if I had to choose between the two, I’d probably reach for the Beyond Pros more often because speech in noise is my biggest challenge.

For anyone interested, here’s the comparison:
https://www.hearadvisor.com/products/compare/elehear-beyond-pro-vs-phonak-audeo-lumity2

That said, if you’re looking for a backup pair of hearing aids and your hearing loss is mild to moderate, I think the Beyond Pros are an excellent option, especially considering their price. Of course, everyone’s hearing loss and listening needs are different, so your experience may not be the same as mine.

Thanks for bringing these to our attention. What is quite frustrating (for me) is that all these OTC devices only address mild-to moderate hearing loss. It occurs to me that engineering extra output power (delivered by standard receivers) is not a major challenge; so easy, in fact, that the output of standard earbuds is even capped by law in the EU. I guess the answer is that those with sub-50 db hearing loss represent by far the largest market, but also perhaps because regulators believe consumers aren’t smart enough to properly fit their own HAs safely.

Not really an oversimplification, those are the elements. However the fixes for feedback aren’t always obvious to a new user and represent a raft of potential issues to the supplier. If you state at the outset that the aids are only suitable for certain losses, the risk of supply is mitigated.

If you’ve got a more severe loss and they work for you, great, but keeping gain stable at higher levels usually needs more controls during fitting as well as more appropriate dome selection. That’s before you get into discrete channel adjustments for feedback control.