Are Hearing Aid Benefit and Satisfaction Rates Higher for Traditional or Over-the-Counter Hearing Aids?

Abstract

Recent regulatory changes in the United States created a category of hearing aids that could be purchased over-the-counter (OTC), directly by a consumer without professional dispensing. Evidence supporting the benefits of OTC hearing aids for adults with perceived mild-to-moderate hearing difficulty is somewhat mixed in the literature. The purpose of this study is to compare hearing aid benefits and satisfaction rates for OTC and traditional, provider-dispensed hearing aids within the MarkeTrak 25 survey data. Results of the survey demonstrate robust benefits and high satisfaction rates for both OTC and traditional hearing aids. However, there are some differences in trends between OTC and traditional hearing aids. Specifically, within owners of traditional hearing aids, there is remarkable stability in terms of benefits, satisfaction rates (83% of hearing aid owners are satisfied), and net promoter scores (+30 points for promoters relative to detractors). These values are essentially unchanged over the last several years, suggesting the introduction of the formal OTC hearing aid category has not affected the benefit or satisfaction rates of traditional hearing aids. The OTC hearing aids themselves have similar benefits as traditional hearing aids, although slightly lower satisfaction rates (76% of OTC hearing aid owners are satisfied). Compared to owners of traditional hearing aids, owners of OTC hearing aids were less likely to be satisfied with the size and reliability of their hearing aids, although they were more likely to be satisfied with the price of the hearing aids. The current data also highlight the importance of professional services, even within the group of OTC hearing aid owners. Not only did most OTC hearing aid owners (approximately 80%) utilize some type of professional service, but those who did receive professional support were more likely to be satisfied with their hearing aids than were those who did not receive professional services. Therefore, although the OTC hearing aids are beneficial and consumers are satisfied with them, professional support continues to be an important and beneficial aspect in the OTC category of hearing aids.

Keywords

hearing aid - over-the-counter - benefit - satisfaction - professional services

In October 2022, regulatory changes in the United States created a category of hearing aids that allowed them to be sold over-the-counter (OTC), directly to adults with perceived mid-to-moderate hearing loss.[1] [2] Before that time, any device labeled as a “hearing aid” could only be purchased through a professional. The category of hearing aids was created largely in response to low hearing aid adoption rates,[3] [4] which were attributed to high cost and limited accessibility.[5] [6] By allowing consumers to purchase devices directly, OTC hearing aids could be more accessible than traditional, professionally dispensed hearing aids, and could be potentially less expensive without the associated professional services. Therefore, OTC hearing aids should improve the affordability and accessibility of hearing aids, increasing hearing aid adoption rates among hearing aid candidates.

However, a lingering question is: do consumers benefit from, and are they satisfied with, their hearing aids if they purchased them “OTC”? Are their satisfaction rates similar to what would be expected if they had pursued hearing aids through a traditional model, where a hearing care professional dispensed the hearing aid(s)? Understanding satisfaction rates is a critical piece in the evaluation of the OTC market. Consumer satisfaction and willingness to promote their experiences are both important to maintaining existing consumers and to attracting new buyers.[7] Therefore, the purpose of this study is to review recent data from the MarkeTrak 25 survey exploring satisfaction rates, factors contributing to satisfaction, and likelihood to recommend hearing aids, for owners of OTC and traditional hearing aids.

Closely related to hearing aid satisfaction is hearing aid benefit, although the constructs of benefit and satisfaction are different.[8] Whereas satisfaction is the degree to which a consumer has a favorable appraisal of their experience within the context of their expectations, benefits are related to improvements in hearing function.[9] [10] There is reason to expect that hearing aid benefit rates could be different from satisfaction rates for OTC hearing aids. For example, existing hearing aids available OTC have been shown to underperform in terms of gain[11] [12] [13] and expected sound quality.[14] However, because of their lower price point and potentially lower expectations for success, consumers might be as satisfied with OTC hearing aids as with higher-cost, better-fit hearing aids.[15] Therefore, an additional purpose of this study is to review the available evidence in the MarkeTrak 25 data related to device benefits for OTC and traditional hearing aids.

Before exploring the differences in hearing aid satisfaction or benefits between OTC and traditional hearing aids, it is important to examine the market from which the ratings were obtained. Therefore, summary information about the MarkeTrak 25 survey respondents and their hearing aids is also presented to contextualize the benefit and satisfaction findings. These summary details about the respondents and their hearing aids are also potentially useful for tracking changes in the hearing aid market over time and for watching the growth of the OTC hearing aid category.

Survey Respondents and Hearing Aids

The details of the MarkeTrak 25 survey data collection are described elsewhere. [16] In brief, the data reported here are from adults living in the United States with perceived hearing difficulties who also wear at least one hearing aid (except where indicated). The hearing aids are either “traditional,” prescription hearing aids in that they were fit by a hearing care professional (number of respondents with traditional hearing aids was 1,008). The other type of hearing aid included in this study is OTC hearing aids, which were obtained directly from a manufacturer outside a traditional service delivery model (number of respondents with OTC hearing aids was 136).

Survey Respondents

The owners of traditional hearing aids were older (mean age = 70 years) than were OTC owners (mean age = 52 years). Traditional hearing aid owners were more likely to be retired (70%) than were OTC hearing aid owners (44%). The owners of traditional hearing aids also reported a higher annual median income ($77,400) than the OTC hearing aid owners ($65,500). The owners of traditional and OTC hearing aids had similar gender ratios, with 56% reporting to be male and 44% reporting to be female. The groups were also similar to each other in their marital status, with 56% reporting to be married or having a significant other across both groups. Across both groups of hearing aid owners (traditional and OTC), 95% of them have cell phones, and 95% of those are smartphones (approximately evenly divided between Android and iPhone operating systems).

Owners of traditional hearing aids were more likely to have bilateral hearing loss (84%) than were owners of OTC hearing aids (66%). Among the owners of traditional hearing aids, 71% had perceived mild-to-moderate hearing loss. Most of the owners of OTC hearing aids had perceived mild to moderate hearing loss (83%). Although one might hope 100% of OTC owners had mild-to-moderate hearing loss, it is encouraging (and expected) that more owners of OTC hearing aids were in that perceived hearing loss category than were owners of traditional hearing aids.

Hearing Aids

The average age of traditional hearing aids was reported to be 4.7 years, and the average age for the OTC hearing aids was reported to be 1.5 years. Traditional and OTC hearing aids were mostly bilaterally fit (83 and 71%, respectively). Consistent with the age of the devices, only 58% of traditional hearing aid owners were first-time buyers, whereas 70% of OTC hearing aid owners were first-time buyers. The median cost per traditional hearing aid was reported to be $1,560, which was significantly higher than the reported median cost ($150) per OTC hearing aid. Most of the traditional hearing aids were purchased from an office or a clinic (84%), whereas 31% of OTC hearing aids were purchased from an office or a clinic. Most of the remaining OTC hearing aids were purchased from a retailer or pharmacy, either in-store (28%) or online (28%). Another 11% of OTC hearing aids were purchased from an online-only retailer.

[Fig. 1] shows a breakdown of general hearing aid styles reported by owners of traditional and OTC hearing aids. The most common hearing aid style reported by owners of traditional hearing aids was a behind-the-ear style (76%), compared to only 23% of traditional hearing aids that fit “only inside of the ear.” This percentage of market share of BTE-style hearing aids is consistent with previous MarkeTrak data; for example, in 2020, 73% of traditional hearing aids were BTEs.[17] Conversely, the market share of BTE devices was much smaller as reported by owners of OTC hearing aids, where only 42% reported using BTE hearing aids and 57% reported using in-the-ear style hearing aids. The breakdown of hearing aid styles within the OTC hearing aids is more consistent with the hearing aid market reported several decades ago, where BTEs were reported by approximately 47% of hearing aid owners from 2005 to 2008.[18]

Figure 1 Percent of respondents who describe their hearing aids as being behind-the-ear style or in-the-ear style for each group of hearing aid owners (total, traditional hearing aids, or over-the-counter hearing aids).

Hearing Aid Features

[Table 1] displays the types of features reported by owners of traditional and OTC hearing aids. The table demonstrates that owners of OTC hearing aids were more likely to report having standard features (e.g., volume controls, rechargeable hearing aids or batteries, telecoils, and tinnitus maskers) than were owners of traditional hearing aids. However, owners of traditional hearing aids were more likely to report having wireless capabilities (e.g., streaming from a smartphone directly) than were owners of OTC devices. Owners of OTC hearing aids were are more likely than owners of traditional hearing aids to report using accessories, like television streams or companion microphones. Among owners of traditional hearing aids, use of television streamers and companion microphones has declined from 27 and 25%, respectively, in 2022. These data suggest the use of these accessories is declining among owners of traditional hearing aids, but not among owners of OTC hearing aids. On the increase, however, are wireless capabilities, which are reported by more than 70% of traditional hearing aid owners, up from 43% as recently as 2015.[19]

Table 1 Hearing aid features and capabilities reported by owners of traditional and OTC hearing aids

		Traditional (n = 742)	OTC (n = 127)
Features	Volume control	73%	84%[a]
	Program button	54%	45%
	Rechargeable hearing aid	67%	80%[a]
	Directional, dual, twin, or multiple microphones	30%	31%
	Rechargeable batteries	17%	35%[a]
	Telecoil	23%	34%[a]
	Tinnitus masker	15%	28%[a]
Wireless capabilities	The ability to “link” volume or program changes	52%	50%
	The ability to stream sound from a smartphone directly	58%[a]	40%
	The ability to stream sound using an additional accessory	33%	39%
	NET: wireless hearing aid (calculated)	72%[a]	60%
Accessories/apps	Downloadable “app” for smartphones	55%	46%
	Hearing aid remote control	35%	37%
	Body-worn Bluetooth device	24%	31%
	TV streamer	16%	29%[a]
	Companion microphone	13%	27%[a]

Note: The specific question respondents answered was, “Below are some different hearing aid features, capabilities, or accessories/apps. Please indicate whether your current hearing aid has each one, as far as you know.” Data are displayed only for respondents who purchased hearing aids within the last 5 years.

^a Indicates significant differences between traditional and OTC at the 90% confidence level; differences are also in bold typeface.

Hearing Aid Benefits

Listening Situations

The hearing aid owners represented in the MarkeTrak 25 survey data were generally satisfied with their ability to hear in many listening situations, especially compared to nonowners. The nonowners are adults who report similar difficulty hearing but have not adopted hearing aids (see participant sample description in Dobyan and Kihm, 2025).[16] Overall, 43% of nonowners were satisfied with their ability to hear across all listening situations, whereas 79% of traditional and 76% of OTC hearing aid owners reported feeling satisfied with their ability to hear across all listening situations. The difference in hearing abilities between owners of traditional and OTC hearing aids was not statistically significant.

Although the difference in hearing ability between owners and nonowners in a variety of situations is not a traditional measure of benefit (classically defined as the difference between performance with and without a hearing aid for the same person), the cross-group comparison in hearing ability could be broadly interpreted as hearing aid benefit. That is, it could be assumed that, without their hearing aids, the hearing aid owners would be less likely to be satisfied with their ability to hear in those listening situations than they are with their hearing aids.

[Fig. 2] further explores the types of listening situations where nonowners, owners of traditional hearing aids, and owners of OTC hearing aids report being satisfied with their ability to hear. In this figure, the situations are rank-ordered by difficulty as reported by adults who do not own hearing aids. This figure demonstrates that the fewest nonowners reported satisfaction with their ability to hear when trying to follow conversations in noise, whereas most respondents, even without hearing aids, were satisfied with their ability to listen to music and to converse with one other person. Also evident in this figure are the situations where hearing aids were the most beneficial (e.g., those at the top of the figure, including in background noise and in large groups), but also the small, statistically nonsignificant differences between perceived listening abilities for adults with traditional and OTC hearing aids. That is, from the perspective of the hearing aid owners, OTC hearing aids can be beneficial across a wide variety of listening situations, similar to traditional hearing aids.

Figure 2 Percent of respondents who report being satisfied with their ability to hear in each listening situation. Groups displayed include adults with hearing difficulty who do not wear hearing aids (nonowners; blue), who own OTC hearing aids (purple), and who own traditional hearing aids (green).

The robust benefits that are similar between traditional and OTC hearing aids are consistent with some existing studies in the literature, showing similar benefits of OTC and traditional hearing aids.[20] [21] [22] [23] [24] However, the current findings are inconsistent with some studies, which show larger benefits with traditional than OTC hearing aids.[25] [26] Although there are a number of methodological differences between these studies (e.g., outcome measures, random assignment, etc.), perhaps the most important difference of note is that the estimated hearing aid benefits in the current study are largely driven by the perceived difficulty of the nonowner group. That is, the hearing aids appear to be the most beneficial in noisy situations in the current study, not because owners are most likely to be satisfied in those situations, but because nonowners are least likely to be satisfied in those situations.

SATISFACTION RATES

The MarkeTrak 25 survey included satisfaction questions, all of which have the same response structure; respondents indicate how satisfied or dissatisfied they are on a scale of 1 to 7, with 1 indicating very dissatisfied and 7 indicating very satisfied. Often in the analysis of the data, scores of 1 to 3 are grouped together and described as “bottom-3 box” scores, capturing the respondents who indicate any degree of dissatisfaction. Similarly, people who indicate a score of 5 to 7 are grouped together to indicate “top-3 box” scores, indicating any degree of satisfaction. Scores of 4 are interpreted as neutral.

Hearing Aid Satisfaction

As displayed in [Fig. 3], hearing aid satisfaction rates are high overall; 82% of all hearing aid owners report being satisfied with their hearing aid(s). The satisfaction rates with traditional hearing aids have remained stable over the last 10 years, ranging between only 81and 83%.[19] Overall satisfaction rates were only a few points different when traditional and OTC hearing aids were considered separately (83 and 76% of respondents were satisfied, respectively).

Figure 3 Percent of respondents who provided each satisfaction rating overall and for owners of OTC and traditional hearing aids, separately. Also displayed are the overall satisfaction rates for the top-3 box scores overall and for each group.

However, owners of those two hearing aid types varied in how satisfied they were with aspects of hearing aids. As displayed in [Table 2], owners of traditional hearing aids were more satisfied than their OTC counterparts in terms of reliability and size of hearing aids. Owners of OTC hearing aids were more satisfied with the price of their hearing aids than were owners of traditional hearing aids. Both groups of owners were similarly satisfied with the value of the device.

Table 2 Percent of owners of traditional and OTC hearing aids that are satisfied (top-3 box ratings) or dissatisfied (bottom-3 box ratings) with aspects of their hearing aids

	Aspect	% Satisfied (top-3 box)		% Dissatisfied (bottom-3 box)
		Traditional (n = 742)	OTC (n = 127)	Traditional (n = 742)	OTC (n = 127)
Physical	Reliability	86%[a]	77%	5%	10%[a]
	Size	84%[a]	74%	6%	8%
	Physical comfort	81%	76%	7%	13%
	Appearance	81%	79%	3%	8%[ a ]
	Visibility to others	79%	79%	5%	10%[a]
Sound	Clarity of tone and sound	79%	77%	9%	10%
	Degree it manages whistling/feedback	79%	70%	8%	12%
	How natural things sound	79%	71%	8%	9%
	Richness or fidelity of sound	78%	75%	7%	9%
	Ability to tell the direction of sound	78%	74%	8%	14%[a]
	Comfort when listening to loud sounds	74%	76%	11%	7%
	Ability to minimize background noise	67%	69%	14%	16%
Usage	Ease of charging the battery	87%	83%	3%	6%
	Ease of use	86%	81%	5%	5%
	Battery life	80%	76%	7%	9%
	Ease of cleaning/care	79%	77%	5%	8%
	Ease of changing the battery	78%	76%	6%	7%
Price/value	Overall value	83%	80%	6%	7%
	Out-of-pocket price paid	69%	85%[a]	15%[a]	4%

Note: Owners are those who got their hearing aids within the last 5 years.

^a Indicates significant differences between traditional and OTC hearing aids at the 95% confidence level; differences are also in bold typeface.

Demographic Factors Related to Satisfaction

[Table 3] displays differences between owners of traditional and OTC hearing aids who were (top-3 box) and were not satisfied (combined neutral and bottom-3 box). Evident in this table are factors that contribute to satisfaction. Specifically, among owners of OTC hearing aids, males were more likely to be satisfied with their hearing aids than were females. Also, among owners of OTC hearing aids, college graduates were more likely to be satisfied with traditional hearing aids than with OTC hearing aids. For both groups (owners of traditional and OTC hearing aids), those with higher annual household incomes were more likely to be satisfied with their hearing aids. Although owners of OTC hearing aids were younger than owners of traditional hearing aids, age did not seem to affect device satisfaction within either group.

Table 3 Demographic differences between satisfied and neutral/not satisfied owners of traditional and over-the-counter hearing aids

		Traditional hearing aid owners		OTC hearing aid owners
		Satisfied (top-3 box; n = 830)	Neutral/not satisfied (n = 172)	Satisfied (top-3 box; n = 103)	Neutral/not satisfied (n = 33)[b]
Age	Average age	70	69	53	51
	% Less than 35	6%	6%	26%	38%
	% 35–64	20%	24%	31%	15%
	% 65+	74%	70%	43%	47%
Gender	% Male	57%	54%	63%[a]	35%
	% Female	43%	46%	37%	65%[a]
Education and income	% College degree	49%	42%	43%[a]	17%
	Average income	$95,700[a]	$76,600	$88,200[a]	$53,700

^a Indicates significant differences between percentages of satisfied and not satisfied respondents at the 95% confidence level; differences are also in bold typeface.

^b Relatively small sample size.

Device Factors Related to Satisfaction

[Table 4] displays differences between satisfied and unsatisfied owners on some hearing aid device factors. Interestingly, the only driver of satisfaction specific to the device was price; even then, it was only evident among owners of OTC hearing aids. Specifically, owners of OTC hearing aids who were satisfied paid more for their devices (median: $584) than did owners who were not satisfied (median: $272). The role of hearing aid cost for satisfaction rates is consistent with the finding that higher cost OTC hearing aids have better design aesthetics and electroacoustic properties.[13] Within the owners of traditional hearing aids, price did not meaningfully contribute to ratings of satisfaction; in fact, the trend was in the other direction, where satisfied owners of traditional hearing aids paid less (median: $1,690) than did nonsatisfied owners (median: $1,800).

Table 4 Device and service-delivery differences between satisfied and neutral/not satisfied owners of traditional and over-the-counter hearing aids

		Traditional hearing aid owners		OTC hearing aid owners
		Satisfied (top-3 box)	Neutral/not satisfied	Satisfied (top-3 box)	Neutral/not satisfied
Age of hearing aid		(n = 794)	(n = 161)	(n = 99)[b]	(n = 33)[b]
	Average age of the most recent hearing aid	4 y	4 y	2 y	1 y
Price of a hearing aid		(n = 438)	(n = 65)	(n = 62)[b]	(n = 18)[b]
	Average price	$1,690	$1,800	$584[a]	$272
Purchase place		(n = 830)	(n = 172)	(n = 103)	(n = 33)[b]
	Office, clinic, or center	81%	87%	24%	36%
	Retailer or pharmacy—in-store	17%	9%	29%	15%
	Retailer, pharmacy, or HA brand's website	1%	1%	32%	36%
	Online-only retailer (e.g., Amazon)	0%	0%	14%	9%
	Somewhere else	1%	2%	1%	3%

Note: Price is reported for only those respondents who could recall the price paid.

^a Indicates significant differences between satisfied and not satisfied respondents at the 90% confidence level; differences are also in bold typeface.

^b Relatively small sample size.

Importance of Professional Services

Finally, accessing professional services was related to device satisfaction. As shown in [Fig. 4], those who received some hearing care professional assistance were more satisfied than those who did not receive any professional services. Because almost 100% of owners of traditional hearing aids received professional services, this difference in satisfaction between those who did and did not receive professional services is largely due to the OTC hearing aid category. Among owners of OTC hearing aids, only one in five did not receive any kind of professional services; 72% of OTC owners received a professional evaluation, 59% received help selecting a device, and 56% received help getting fitted initially. This combination of findings highlights both the prevalence and importance of hearing care professionals in the dispensing and support of hearing aids, even in an OTC service-delivery model. This finding adds to a growing body of literature demonstrating that professional services are important for success for some people, even with devices that are designed to be delivered directly to consumers.[27]

Figure 4 Percent of respondents who provided each satisfaction rating based on whether or not they received professional services (specifically an evaluation, selection, or fitting).

Recommendations to Others

Most hearing aid owners (83%) would recommend a hearing aid to a friend or family member. However, the percentage is higher for owners of traditional hearing aids (85%) than for owners of OTC hearing aids (73%). Consistent with this finding, net promoter scores (NPS) were higher for owners of traditional than OTC hearing aids. An NPS indicates loyalty based on the likelihood of recommendations.[28] In this case, respondents rated how likely they were to recommend the establishment from which they bought their hearing aid(s). The likelihood scores range from 0 to 10, with scores 0 to 6 indicating a respondent is a “detractor,” scores of 7 or 8 indicating a respondent is a “passive,” and scores of 9 or 10 indicating a respondent is a “promoter.” The NPS is the calculated difference between the percent of respondents who were “promoters” and “detractors.” A positive NPS indicates an establishment is likely to be recommended, whereas a score near 0 indicates neutrality (an establishment is neither likely nor unlikely to be recommended). Although the relationships are imperfect, the NPS has been related to brand growth[29] [30] and customer loyalty.[31] Therefore, NPSs not only provide insights into device satisfaction, but they could also be informative for predicting future trends of market growth or customer maintenance.

In the MarkeTrak 25 data, the NPS overall for hearing aid owners was quite positive, at +25, suggesting more people were likely to recommend than detract the establishment from where they purchased their hearing aids (see [Fig. 5]). However, there was an important difference in NPS between owners of traditional and OTC hearing aids, with the former being quite positive (+30) and the latter being neutral (0). These data are remarkably similar to the data from MarkeTrak 2022, where the NPS for the traditional hearing aids was 30.4 and the NPSs for remote- and self-fit hearing aids (categories comparable to the OTC category in 2025) were −4 and +3, respectively.[19]

Figure 5 Net promoter scores overall and for each type of hearing aid (OTC or traditional). Displayed are the percentages of respondents who are detractors, neutral, and promoters, in addition to the overall net promoter score.

The difference between owners of traditional and OTC hearing aids was driven not by passives, but by detractors (as seen in [Fig. 5]). Nearly 40% of owners of OTC hearing aids were detractors, and thus unlikely to recommend that a friend follow a similar path to theirs in getting an OTC hearing aid. This suggests that the OTC hearing aids are not inspiring market growth because they are not likely to be recommended overall and, in some cases, are likely to be recommended against. If the NPSs do not improve for OTC hearing aid brands, the OTC hearing aid market might not grow. As the market continues to evolve, it will be important to continue to monitor the NPSs.

Future Directions

There are a couple of important factors to consider in terms of the generalizability of these findings, all of which are directions for future exploration. First, the MarkeTrak survey results are inherently cross-sectional, providing information at the group level. Although some evidence suggests similarity in outcomes between traditional and self-fit devices using designs that are between-groups[20] [21] [24] or within-participant,[22] [23] the degree to which a traditional or OTC hearing aid is appropriate for a given individual is not addressed with these data because respondents self-selected their devices.

The MarkeTrak 25 data provide insights into the self-selection bias (e.g., owners of OTC hearing aids are younger, with less hearing difficulty than owners of traditional hearing aids). There are some hints in the current data that some owners of OTC hearing aids could benefit instead from traditional hearing aids, or at least from having more support from hearing care professionals. For example, although 66% of OTC hearing aid owners reported having bilateral hearing loss, 71% of them reported having bilateral hearing aids. This suggests that the hearing aids are not well-matched to some owners' hearing ability. Furthermore, more than half of owners of OTC hearing aids reported that they thought a hearing care professional could have helped either a great deal (30%) or moderately (29%), suggesting they pursued a direct-to-consumer model, but would have benefited from having professional services. Future work is warranted to explore whether the self-selection into a particular device category is largely appropriate for most consumers or if a subset of consumers would actually be more satisfied or benefit more from the alternative device type.

Related, the comparison between OTC and traditional hearing aids is somewhat complicated by the degree of hearing difficulty, which is largely not addressed in this data set. Owners of traditional hearing aids were more likely to have bilateral hearing loss and were less likely to have “mild-to-moderate” hearing loss than were owners of OTC hearing aids. Because OTC hearing aids were designed specifically for adults with perceived mild-to-moderate hearing loss, one would expect benefit and satisfaction ratings for OTC and traditional hearing aids to diverge if the adults in the OTC category had more significant hearing losses. That is, the conclusion that traditional and OTC hearing aids are similarly beneficial and satisfactory primarily applies to the population of people for whom OTC hearing aids are appropriate. The current data do not offer insights into the expansion of the OTC candidacy to adults with more than a perceived mild to moderate hearing loss.

Finally, it is not clear which devices, or even which type of OTC devices, are represented in the data. There are a multitude of ways to obtain OTC hearing aids[32] and there is variability in the OTC hearing aid market,[33] which means that the services, usability, and devices vary considerably. The variability means the OTC hearing aids described in the current data set could be reasonably expected to represent a wide range of electroacoustic capabilities and expected sound quality.[13] [14] For example, one important distinction within the existing literature is the difference between OTC hearing aids whose gain configurations are preset or are the result of self-fitting, user interactions. Using self-fit hearing aids, in comparison to professionally-fit, several studies have shown similarity in outcomes.[20] [21] [22] [23] [24] Conversely, using OTC hearing aids with presets, instead of self-fitting functionality, studies have demonstrated the inferiority of OTC hearing aids on some outcome measures.[25] [26] Future work is warranted to disentangle the type of device from the service model in terms of hearing aid benefit and satisfaction.

Conclusion

Results of the MarkeTrak 25 survey demonstrate robust benefits and high satisfaction rates for both OTC and traditional hearing aids. However, there are some differences in trends between OTC and traditional hearing aids. Specifically, within traditional hearing aids, there is remarkable stability in terms of benefits, satisfaction rates (83% of hearing aid owners are satisfied), and NPS (+30 points for promoters relative to detractors) compared to previous years [16, 18]. These values are essentially unchanged over the last several years, suggesting the introduction of the formal OTC hearing aid category has not affected the benefit or satisfaction of traditional hearing aids. The OTC hearing aids themselves have similar benefits as traditional hearing aids, although slightly lower satisfaction rates (76% of OTC hearing aid owners are satisfied). Compared to owners of traditional hearing aids, owners of OTC hearing aids were less likely to be satisfied with the size and reliability of their hearing aids, although they were more likely to be satisfied with the price of the hearing aids. The current data also highlight the importance of professional services, even within the group of OTC hearing aid owners. Not only did most OTC hearing aid owners (approximately 80%) utilize some type of professional service, but those who did receive professional support were more likely to be satisfied with their hearing aids than were those who did not receive professional services. Therefore, although the OTC hearing aids are beneficial and consumers are satisfied with them, professional support continues to be an important and beneficial aspect in the OTC category of hearing aids.

Conflict of Interest

None declared.

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Publication History

Article published online:
11 November 2025