Hearing Aid Adoption in the OTC Hearing Aid Era: Market Trends and Consumer Insights from MarkeTrak 2025

Abstract

The 2025 iteration of the MarkeTrak survey offers a comprehensive analysis of hearing aid adoption trends in the United States, with a particular focus on the impact of over-the-counter (OTC) hearing aids introduced in 2022. This study explores evolving consumer behaviors, demographic shifts, and clinical and psychosocial factors influencing hearing aid uptake. Findings reveal a continued increase in overall adoption rates, with OTC devices serving as a critical access point for first-time users—particularly younger, more diverse, and cost-sensitive populations. Despite the affordability and accessibility of OTC devices, traditional hearing aids remain the preferred choice among individuals with more severe hearing loss and those seeking professional support. The report highlights key differences in service delivery, satisfaction, and repurchase intentions between user groups, underscoring the enduring value of professional care. Additionally, the emergence of hearing improvement features in consumer electronics, such as earbuds, signals a broadening of the hearing device landscape. These insights have significant implications for clinical practice, marketing strategies, and policy development, emphasizing the need for flexible, patient-centered care models that accommodate diverse consumer pathways and preferences.

Keywords

hearing aids - OTC - consumer satisfaction

It is estimated that about one in every four Americans (60 million) ages 12 years and older has a clinically significant hearing loss in one or both ears (Goman & Lin, 2016). However, previous literature has consistently demonstrated a discrepancy between rates of audiometrically identified hearing loss and the prevalence of self-reported hearing issues (Curti et al., 2019). Both clinical and self-report hearing measures serve as predictors of hearing aid adoption (Meyer & Hickson, 2012; Ng & Loke, 2015), with the latter demonstrating more influence on uptake such that those with perceived hearing difficulties are more than 16 times as likely to report use of a hearing aid (Curti et al., 2019).

Hearing aid adoption rates in the United States have historically remained below those of other developed countries but have been steadily increasing in recent years (Powers & Bisgaard, 2022). Lower adoption rates of hearing aids in the United States may be due to factors such as stigma (Wallhagen, 2010), social determinants of health (Schuh & Bush, 2022), or cost (Sternasty & Dhar, 2021). Barriers to hearing aid adoption were the primary reasons for the creation of a new classification of hearing aids that was implemented in 2022 (FDA Reauthorization Act of 2017, 2017; Food and Drug Administration, 2022). This new OTC classification of hearing aids is indicated for adults with perceived mild to moderate hearing issues and does not require the involvement of a licensed professional, a stark change from the previous procurement model of traditional hearing aids dispensed through regulated, licensed professionals. The OTC classification was intended to decrease costs while improving accessibility to hearing devices and promoting earlier help-seeking for hearing issues. OTC hearing aids were not intended to replace traditional hearing aids but instead to provide additional, more accessible options with the goals of boosting consumer autonomy and increasing competition and innovation within the hearing aid market.

The most recent iteration of the MarkeTrak survey, MT2025, includes additional questions about OTC hearing aids to better understand market changes and consumer behaviors in the new OTC hearing aid era. As part of these hearing device market changes, some consumer electronics manufacturers have added hearing aid features to their existing headphone products starting in 2024. Survey questions on these earbud-style headphones with integrated hearing aid features also were included for the first time in MT2025.

MT2025 refined device definitions to accommodate the new OTC classification of hearing aids and recent releases of headphones with hearing improvement features. Specifically, MT2025 defined hearing aids as traditional or OTC and maintained cochlear implants and headphones/earbuds with hearing improvement features as separate and distinct categories of hearing devices. Similar to previous survey iterations, MT2025 defines hearing care professionals (HCPs) to be inclusive of audiologists, hearing instrument specialists, and ear, nose, and throat (ENT) physicians. This most recent survey iteration also includes information on various access points (e.g., in-person, remote, online, etc.). It is important to investigate hearing aid adoption preferences and behaviors in this new era, given the substantive market changes that have occurred since the last survey in 2022.

Overall Adoption Trends

Historical Context and Current Rates

The MarkeTrak survey has followed hearing aid adoption rates since its inception in 1989, demonstrating a steady rise from 23% in 1989, 30% in 2015, and 39% in 2025 (Carr & Kihm, 2022). Adoption rates since 1989 are presented in [Fig. 1]. The United States' uptake rate is now more consistent with other developed countries in Europe (Powers & Bisgaard, 2022). The novel classification of OTC hearing aids is a burgeoning market force since their inception in 2022. Survey results from MT2025 estimate that 33.5% out of the 39% of users adopted traditional hearing aids, and 5.7% adopted OTC hearing aids. Moreover, additional consumer-driven hearing device options became available in 2024 (e.g., earbuds with HI features). The growth of this earbud market segment is noteworthy, where 20.9% of those reporting hearing difficulty indicate using earbuds with a HI feature. It is likely that the addition of HI features with existing and familiar consumer electronics (i.e., earbuds) and increased market penetration of OTC hearing aids have contributed to increases in hearing aid adoption rates in this latest survey iteration and are being noted within other healthcare sectors, such as vital sign monitoring via wearable devices (Trinh et al., 2025).

Figure 1 Historical MarkeTrak hearing aid adoption rates in the United States. (Hearing Industries Association).

First-Time Buyer Patterns

Availability of OTC hearing aids has challenged traditional market entry pathways, with 70% of first-time buyers adopting OTC devices in MT2025 results (see [Fig. 2]). By comparison, 58% of those using traditional hearing aids were first-time buyers. This large segment of OTC hearing aid owners is overwhelmingly first-time users, a finding that is consistent with the intention to improve accessibility with the novel classification of OTC devices released in 2022. While first-time buyer rates among traditional hearing aid users have stayed relatively stable (57% in 2015, 56% in 2019, and 51% in 2022), comparison data for the OTC first-time buyers will not be available until the next survey iteration, as these survey questions were first added in 2025. However, if OTC hearing aid first-time ownership rates prove to be similar to those of traditional hearing aids, they may continue to constitute a large proportion of first-time buyers and a significant first-time adopter market segment.

Figure 2 First-time buyer rates by hearing aid type. (MarkeTrak 2025, Hearing Industries Association).

Demographic Differences in Adoption

As market trends have changed with the advent of OTC hearing aids, investigation of demographic differences in adoption can be useful to better understand these consumer choices and inform targeted marketing to population segments consistent with their observed purchase preferences. Traditional hearing aid owners continue to be older, White, college-educated, retired, and report higher incomes compared to OTC hearing aid owners, who were younger, self-identified as Black, Indigenous, and People of Color (BIPOC), were still active in the workforce, and reported lower incomes. Specifically, traditional hearing aid adoption rates were 35% among White respondents and 29% among those identifying as BIPOC, whereas OTC adoption rates were 5% among White respondents and 8% among BIPOC segments. Adoption rates by race/ethnicity and those within specific race/ethnicity groups are presented in [Fig. 3].

Figure 3 Hearing aid adoption rates by race/ethnicity and device type. (MarkeTrak 2025, Hearing Industries Association).

Among hearing aid owners, the median age for those using traditional hearing aids was 73 years, while OTC hearing aid owners had a median age of 58. The median age for first-time buyers, regardless of device type, has stayed stable at 70 years since MT2019, but comparisons by device type are not available prior to MT2025. Adoption rates by sex remain fairly equal, despite the prevalence of hearing loss being higher among males. Income remains a strong driver for traditional hearing aid ownership, but is less varied for OTC hearing aid adoption. For example, traditional hearing aid owners reporting less than $50K income have uptake rates of 29% compared to those with incomes of $100K or greater at 35%. By comparison, adoption rates for OTC hearing aids were 5 and 6% for those with < $50K income and $100K or greater, respectively. These demographic differences in adoption are relevant not only within the healthcare market but may also signal continued accessibility disparities for traditional hearing aids among non-White groups and those with lower incomes.

Clinical and Personal Factors

Self-Reported Hearing Loss Severity

Self-reported hearing difficulty has proven to be a better predictor of hearing aid adoption than audiometrically measured hearing loss (Meyer & Hickson, 2012; Ng & Loke, 2015). Consistent with previous literature and MarkeTrak survey iterations, adoption rates across all device types demonstrate an upward trend as self-rated hearing difficulties become more severe. For traditional hearing aids, the lowest uptake rates were noted for the mild self-report group (18%), increasing to 47% for moderate and 66% for severe. Interestingly, traditional hearing aid adoption rates trended downward for the self-perceived profound group at 48%, but a small sample size in this group impedes meaningful interpretation of those findings (n = 72). For those who wore earbuds with HI features, the adoption rates were relatively steady across severity groups (16% adoption rate for mild, 21% for moderate, 21% for severe, and 16% for profound). These findings may indicate that individuals who perceive their hearing difficulties to be greater than mild are seeking traditional hearing aids as opposed to consumer-driven earbud options. Exploration by MarketTrak's six-level self-perceived severity grouping revealed that those with more extreme hearing difficulties had higher adoption rates than those who perceived their hearing issues as less severe. Indeed, over half of those in the highest two severity categories have obtained hearing aids, whereas the lower severity categories had adoption rates ranging from 21 to 39%.

Monaural versus Binaural Adoption Rates

Consistent with previous studies, the preponderance of hearing aids is obtained or fitted in the bilateral condition (Nassiri et al., 2021) and supports favorable outcomes (Zobay et al., 2023). MT2025 found that among those with hearing difficulties in one or both ears, the binaural adoption rate across all device types is 81%. Among hearing aid owners with bilateral hearing concerns, the binaural adoption rate is higher at 93%. Only 71% of OTC hearing aid adoptions were bilateral, which is consistent with MT2025's findings on laterality of hearing concerns; OTC owners report lower rates of bilateral hearing concerns (66%) compared to those with traditional hearing aids (84%). It remains unknown as to why the group of OTC hearing aid owners reports lower rates of bilateral hearing issues compared to previous trends for traditional hearing aid users. This is an area for future investigation in subsequent iterations of this survey.

Duration of Hearing Concerns

Among the entire sample reporting any level of hearing difficulty, individuals are aware of hearing difficulties for an average of 10.3 years prior to taking action. Hearing aid owners have been aware of their issues longer (11.2 years) compared to nonowners (9.6 years), which is likely explained in part by findings that hearing aid owners are generally older (average of 68 years) than nonowners (average of 57 years). When limiting to only OTC hearing aid owners, this group has become aware of their hearing issues more recently (5.3 years) compared to traditional hearing aid owners (12.7 years). The shorter duration of awareness prior to hearing aid purchase is likely due to the observed younger demographic of OTC hearing aid purchasers (average age of 52 years) compared to traditional hearing aid owners (average age of 70 years). A shorter length of time between awareness and help-seeking action among OTC users is encouraging and consistent with the creation of the new OTC device classification: improved accessibility can lead to earlier intervention for hearing loss.

Cognitive Health Connections

With increased scientific and media attention on healthy hearing and cognition, it is encouraging to see that about one quarter of respondents noted that they thought cognition issues were associated with hearing loss. Similarly, these associations secondarily manifested in measures of self-reported forgetfulness, where hearing aid owners reported less frequent episodes of forgetfulness (42%) compared to nonowners (68%). Although this is not a causal relationship, it stands to reason that individuals who use hearing aids would rate their memory—one among many cognitive skills—to be better than nonusers. While the influences of hearing aids on cognition are not well understood, factors such as improved audibility with hearing aids could reduce missing information, which may appear to be forgetfulness simply by providing better access to auditory information and/or freeing up cognitive resources from speech understanding to more complex cognitive tasks (e.g., memory; Powell et al., 2021).

Psychosocial Factors

Stigma associated with hearing aid use continues to be a consideration for hearing help-seekers. However, MT2025 results found that two-thirds of hearing aid owners reported never feeling embarrassed because of their hearing aids. Conversely, only 15% of nonowners with comparable self-reported hearing difficulties reported never being embarrassed by their hearing loss. This may indicate that hearing aid owners feel that hearing aids bring them more certainty in their self-image or communication efficacy compared to nonusers. This key finding can be a useful counseling or marketing tool in demonstrating the effects of untreated hearing loss on psychosocial functioning and self-esteem.

Device Type and Usage Patterns

Usage Frequency and Duration

Adoption rates illustrate the number of people who obtain hearing aids who could benefit from them, while usage rates indicate the amount of time that the devices are used. Regular use is one among many indicators of user success with hearing aids. MT2025 queried participants on the average time they wear their hearing aids and the average number of hours per day they use their devices. Over two-thirds (67%) of hearing aid owners (n = 2,172) reported using their devices daily (see [Fig. 4]). While this may seem encouraging, the remaining 33% of hearing aid owners report weekly, monthly, or less frequent average usage rates, which are far below what is clinically recommended. Compared to previous survey iterations, the percentage of respondents reporting daily usage decreased slightly, regardless of device type. For traditional hearing aids, 69% reported using their devices daily compared to 72% in MT2015, 73% in MT2019, and 67% in MT2022. The modest year-over-year decreases in the number of persons reporting daily use of devices may be explained by fewer opportunities for social engagement during the pandemic and residual pandemic-era impacts, which may have created a new normal with fewer social interactions postpandemic. Compared to traditional hearing aids, the percentage of daily use was lower for OTC hearing aid owners, with only 55% reporting daily use. Lower rates of regular use of OTC hearing aids may be because those who purchased OTC devices were more likely to have milder hearing losses and thus perceive less need for or benefit from robust daily use.

Figure 4 Average hearing aid usage rates. (MarkeTrak 2025, Hearing Industries Association).

The reported daily usage rates varied widely with an average of 9 hours per day overall, and 10.6 hours per day for those who report daily usage. Among current hearing aid users (n = 1,773), 32% reported 5 to 8 hours per day of use, 28% with 9 to 12 hours, and 21% with 13+ hours. There is literature that suggests an average of 8 hours per day of use or greater supports acclimation to aided listening and boosts acoustic and nonacoustic benefits with hearing devices (National Guideline Centre, 2018). Nearly half (49%) of current hearing aid users utilize their devices consistently with clinical recommendations for adults. The remaining 51% who do not use their devices at least 8 hours per day represent an opportunity within follow-up care to develop person-centered strategies for increasing daily use, whether through additional hearing aid programming or counseling.

Consumer Preferences and Influences on Decision-Making

Purchase Channels and Professional Involvement

The landscape of hearing aid acquisition continues to evolve, with distinct differences in purchase channels and professional involvement between traditional and OTC hearing aid users. Traditional hearing aid owners overwhelmingly rely on clinic-based establishments that specialize in hearing healthcare. These settings offer comprehensive support, including professional evaluations, device selection assistance, and in-person fittings. In contrast, OTC hearing aid users access devices through a variety of channels, including online-only retailers and general retail or pharmacy outlets. This diversity in access points reflects the broader consumer-driven nature of the OTC market, which emphasizes convenience and affordability.

Despite the more independent nature of OTC hearing aid purchases, professional involvement is not absent (see [Fig. 5]). A growing number of HCPs are engaging with patients about OTC device options. Approximately 86% of OTC hearing aid users have discussed their hearing issues with an HCP, and many report receiving recommendations from medical professionals, including general practitioners and ENT physicians. This trend suggests a shift in the professional community's approach, recognizing the role of OTC devices in expanding access to hearing care. Notably, OTC device users are more likely to have remote or virtual consultations, reflecting the category's alignment with digital health trends.

Figure 5 Service options received among hearing aid users. (MarkeTrak 2025, Hearing Industries Association).

Remote fitting services also are gaining traction across both user groups. While nearly all traditional users receive in-person fittings, a significant portion of OTC hearing aid users—over half—report receiving some form of remote fitting assistance. This expansion of tele-audiology services underscores the industry's adaptation to consumer preferences for flexibility and digital engagement. However, disparities remain: one in five OTC users report receiving no professional assistance at all, a stark contrast to the full-service model experienced by traditional users. These differences in service models have implications for user satisfaction, device performance, and long-term adherence, and they highlight the need for continued integration of professional support within the OTC hearing aid framework.

Motivations and Decision-Making Influences

Understanding the motivations behind hearing aid adoption reveals important distinctions between traditional and OTC hearing aid users. Across the board, the desire to improve hearing remains the most cited motivator, followed closely by professional recommendations and encouragement from family members. These intrinsic and extrinsic drivers are particularly strong among traditional hearing aid users, who are more likely to report taking action based on a healthcare provider's advice. In fact, 68% of traditional hearing aid users cite professional recommendation as a key influence, compared to 46% of OTC hearing aid users. This reliance on professional guidance reflects the clinical orientation of the traditional hearing aid pathway.

OTC hearing aid users, on the other hand, are more influenced by factors such as price, convenience, and exposure through online and social media channels. Nearly half of OTC device users report being drawn to establishments offering inexpensive hearing aids or special deals, and many are motivated by the ease of online navigation and the opportunity to try something new. Social media also plays a more prominent role in the decision-making process for OTC hearing aid users, who are significantly more active on platforms like Facebook and YouTube. These findings suggest that OTC device users are more likely to engage in self-directed research and to be swayed by consumer-facing marketing strategies.

The decision-making process also diverges when it comes to selecting a specific device. Traditional hearing aid users prioritize trust in the provider, insurance coverage, and the perceived reliability of the device. They are more likely to choose a hearing aid based on a professional's recommendation or the reputation of the establishment. In contrast, OTC device users emphasize affordability and accessibility, often selecting devices based on price and online reviews. These patterns reflect broader differences in consumer behavior and underscore the importance of tailoring communication and support strategies to the unique needs of each user group.

Economic Factors and Coverage

Economic considerations continue to play a pivotal role in hearing aid adoption, with significant cost differences between traditional and over-the-counter (OTC) devices (see [Fig. 6]). According to the MT2025 MarkeTrak report, the average cost of a traditional hearing aid is approximately $1,700 per device, with a median cost of $1,560. In contrast, OTC hearing aids average $510, with a median cost of just $150. Despite the lower price point of OTC devices, the total system cost for bilateral traditional hearing aids remains high, often approaching $3,000. This financial burden may deter some individuals from pursuing traditional hearing solutions, particularly those without adequate insurance coverage or financial support.

Figure 6 Per hearing aid cost, inclusive of out-of-pocket cost and insurance coverage. (MarkeTrak 2025, Hearing Industries Association).

In addition to the cost differential, insurance coverage plays a significant role in hearing aid adoption. While coverage has grown from 48% in 2015 to 63% in 2025, disparities remain. Additionally, wide variability in coverage amounts for hearing aids continues to be observed across plans, with many insurers providing little or no coverage for related professional HCP services when devices are obtained (Arnold et al., 2017). Sixty percent of traditional hearing aid users utilize their coverage, compared to just 36% of OTC users. Medicare Advantage plans have likely contributed to this growth, correlating with increased uptake. However, underinsured populations continue to be disproportionately represented among nonadopters, suggesting that lack of adequate coverage for devices and associated hearing care services may still be a barrier to broader adoption.

Interestingly, despite the stark contrast in out-of-pocket expenses, satisfaction with overall value remains comparable between traditional and OTC hearing aid users. This parity may reflect differing expectations and priorities: traditional users often cite reliability, device size, and professional support as key satisfaction drivers, while OTC device users emphasize affordability and ease of access. Nonetheless, the persistent gap in insurance utilization and the high total cost of traditional systems underscore the importance of expanding coverage options and improving affordability to ensure equitable access to hearing healthcare.

Satisfaction and Perceived Value

Satisfaction with hearing aids remains a critical metric in evaluating the effectiveness and perceived value of hearing healthcare solutions. Overall satisfaction among hearing aid users continues to be high, with 83% of traditional hearing aid owners and 76% of OTC hearing aid owners reporting satisfaction with their devices. While the difference in top-three box satisfaction ratings between the two groups is not statistically significant at the 95% confidence level, traditional users are more likely to report being very satisfied, suggesting a deeper level of contentment with their devices.

The drivers of satisfaction vary notably between traditional and OTC hearing aid users. Traditional hearing aid owners express higher satisfaction with reliability, device size, and the extent to which their expectations are met. These attributes are consistently cited as key differentiators and remain areas where OTC devices lag. Conversely, OTC hearing aid users report greater satisfaction with the price paid, reflecting the affordability advantage of this category. Interestingly, both groups report similar levels of satisfaction with the overall value of their devices, indicating that despite differences in specific attributes, users perceive a comparable return on investment.

Demographic insights further contextualize these findings. Traditional hearing aid users tend to report more severe degrees of hearing loss and are more likely to be older, aligning with their higher expectations for device performance and reliability. OTC device users, who typically report mild-to-moderate hearing loss, are often younger and more price-sensitive, which may explain their emphasis on affordability and convenience. This segmentation underscores the importance of tailoring device offerings and support services to meet the distinct needs of each user group.

The relationship between perceived hearing loss severity and satisfaction is also noteworthy. Satisfaction rates increase with the self-reported severity of hearing loss, peaking among those who classify their loss as severe. This trend suggests that individuals with more pronounced hearing challenges may experience greater perceived benefit from amplification, thereby enhancing their overall satisfaction.

These findings set the stage for understanding future intentions and market shifts, as satisfaction and perceived value are likely to influence repurchase intentions and category loyalty. As the market continues to evolve, particularly with the growing presence of OTC devices, ongoing monitoring of satisfaction drivers will be essential to ensure that hearing aid offerings align with user expectations and clinical needs.

Future Intentions and Market Shifts in Hearing Aid Use

MT2025 provides a comprehensive update on consumer intentions and market dynamics in the hearing aid sector, highlighting significant shifts in repurchase behavior and device preferences. Compared to the 2022 findings, the latest data suggests a nuanced evolution in consumer attitudes, particularly among users of OTC and traditional hearing aids.

Repurchase intentions remain robust among traditional hearing aid users, with 61% indicating plans to repurchase within the next 4 years. This figure reflects the aging profile of traditional devices, which average 4.7 years in age, and underscores the continued loyalty of this segment. In contrast, only 43% of OTC hearing aid users plan to repurchase in the same timeframe. This lower rate may be attributed to the relative novelty of OTC devices, which average just 1.5 years in age, and the more exploratory nature of their users.

Device switching patterns reveal that OTC hearing aids are increasingly serving as an entry point into the broader hearing healthcare market (see [Fig. 7]). Among current OTC users, 38% intend to switch to traditional hearing aids for their next purchase, suggesting that initial experiences with OTC devices may prompt users to seek more comprehensive solutions. Conversely, traditional hearing aid users exhibit strong category loyalty, with very few indicating an intention to switch to OTC options. This asymmetry in switching behavior reinforces the perception of OTC devices as a gateway rather than a substitute.

Figure 7 Purchase intentions within the next 3 years. (MarkeTrak 2025, Hearing Industries Association).

These trends have important implications for market segmentation and service delivery. The demographic profiles of OTC and traditional hearing aid users remain distinct: OTC device users tend to be younger, more likely to be BIPOC, and have lower incomes, while traditional users are typically older, White, college-educated, and retired. The movement of OTC hearing aid users toward traditional devices suggests a maturation of consumer needs and expectations, potentially driven by the desire for greater support, customization, and performance. Importantly, even dissatisfied OTC device users express intentions to repurchase, indicating that initial experiences, while varied, do not deter long-term engagement with hearing solutions.

The MT2025 data affirms the role of OTC hearing aids as a critical access point for underserved populations, while also highlighting the enduring value and satisfaction associated with traditional devices. As the market continues to evolve, these insights will be essential for audiologists and healthcare professionals seeking to tailor interventions and support across diverse consumer segments.

What Does this Mean for Audiology?

The MT2025 data offers critical insights into how and where individuals with hearing loss use their devices, revealing important implications for the hearing industry. As the market continues to evolve with the introduction of OTC hearing aids, audiologists and HCPs are uniquely positioned to adapt their services and messaging to meet the changing needs and preferences of consumers.

One of the most notable findings is the diversity of listening environments where hearing aid users report needing support. These include noisy environments, home and family settings, shopping, work, outdoor activities, leisure time, and educational settings. Traditional hearing aid users tend to prioritize communication in noisy and familial environments, while OTC users—who are generally younger—place greater emphasis on hearing well in dynamic, mobile contexts such as shopping, working, and school. This segmentation underscores the emergence of complementary markets: OTC devices are expanding access to hearing solutions, particularly for younger and more cost-sensitive consumers, without displacing the traditional hearing aid model.

This shift presents both a challenge and an opportunity. There is a growing need for education and support tailored to OTC device users, many of whom may be navigating hearing loss for the first time without professional guidance. Only 51% of OTC device users report receiving full service (evaluation, selection, and fitting), and 20% received no service at all. In contrast, 90% of traditional hearing aid users received full service, and nearly all received some form of professional assistance. These disparities highlight a critical education gap. Audiologists can fill this void by offering accessible, low-cost consultations, virtual support, or educational content that helps OTC users understand their hearing needs and the benefits of professional care.

Importantly, OTC hearing aids are not replacing traditional devices but are instead expanding the market. While 50% of current OTC users plan to repurchase an OTC device, a substantial 38% intend to switch to a traditional hearing aid within the next 3 years. Even dissatisfied OTC users are not abandoning hearing aids altogether—they still plan to repurchase, often shifting toward a traditional pathway. This conversion trend suggests that OTC devices may serve as an entry point into the broader hearing care ecosystem, particularly for younger or first-time users. It also creates a clear opportunity for audiologists to position themselves as trusted guides along the hearing care journey.

Professional recommendations remain a powerful motivator. Among traditional hearing aid users, 68% took action based on a recommendation from a hearing care provider, compared to just 46% of OTC hearing aid users. This influence is even stronger among repeat purchasers, 69% of whom cited professional guidance as a key factor in their decision-making. These findings underscore the enduring value of professional expertise, even in a market increasingly shaped by self-directed purchasing.

Service differentiation is a key lever in this evolving landscape. Traditional hearing aid users overwhelmingly benefit from a comprehensive care model: 90% receive full service, including evaluation, device selection, and fitting, compared to just 51% of OTC hearing aid users. Moreover, only 3% of traditional users report receiving no service, while 20% of OTC hearing aid users fall into this category. These differences are not just procedural—they translate into higher satisfaction, better device usage, and stronger long-term engagement. Traditional users are more likely to wear their devices daily and for longer durations, and they report higher satisfaction with both the physical and functional aspects of their hearing aids.

Audiologists can capitalize on these distinctions by clearly communicating the value of professional care. Services such as real-world listening assessments, lifestyle-based device recommendations, and follow-up care tailored to specific environments (e.g., workplace acoustics or classroom amplification) can significantly enhance perceived value. Clinics also might consider offering OTC hearing aid onboarding packages that include hearing screenings, device optimization, and follow-up support. These services not only improve outcomes for OTC hearing aid users but also create natural touchpoints for future conversion to traditional devices.

From a marketing perspective, these insights suggest a need for more targeted, lifestyle-oriented messaging. Rather than promoting hearing aids solely as medical devices, audiologists can position them as tools for empowerment—enabling better communication at work, more meaningful connections at home, and fuller participation in social and recreational activities. Campaigns can be segmented by age, occupation, or lifestyle, with visuals and language that reflect the environments users care about most. For example, a campaign aimed at younger adults might feature a student using hearing aids in a lecture hall or a professional navigating a busy office, while messaging for older adults might focus on family gatherings or conversations in restaurants.

Finally, the industry must continue to adapt its positioning to reflect the diversity of consumer needs and preferences. The traditional model of in-person, clinic-based care remains essential, particularly for those with more complex hearing loss. At the same time, flexible service models—including hybrid care, remote support, and self-directed tools—will be key to engaging new users and retaining those who begin with OTC hearing aid solutions. By offering flexible service tiers and clearly communicating the value of each, audiologists can meet consumers where they are—whether they're just beginning to explore hearing solutions or are ready for a more advanced device.

When considering marketing using the MT2025 data, the data support a dual-market strategy: one that embraces the accessibility of OTC devices while reinforcing the indispensable role of professional care. Audiologists who adapt to this landscape—by educating, supporting, and guiding users across the continuum—will be well-positioned to thrive in a more complex but ultimately more inclusive hearing care market.

Conclusion

The MarkeTrak 2025 report provides a comprehensive and timely examination of hearing aid adoption in the evolving landscape shaped by the introduction of OTC devices. The findings underscore a steady increase in overall adoption rates, with OTC hearing aids serving as a critical access point for younger, more diverse, and cost-sensitive populations. Traditional hearing aids, however, continue to offer superior satisfaction and remain the preferred choice for individuals with more severe hearing loss and those seeking professional support.

The data reveal important demographic, clinical, and behavioral distinctions between user groups, highlighting the need for tailored service delivery models. The emergence of consumer electronics with hearing improvement features and the growing role of tele-audiology further reflect the diversification of hearing care pathways. Despite these shifts, professional involvement remains a key driver of satisfaction, adherence, and long-term engagement.

For clinicians, the report emphasizes the importance of flexible, patient-centered care models that accommodate a spectrum of consumer needs—from self-directed OTC device users to those requiring comprehensive clinical support. For policymakers, the findings point to the continued need for expanded insurance coverage, public education, and equitable access to hearing healthcare.

Looking ahead, the hearing care industry stands at a pivotal juncture. The coexistence of traditional and OTC hearing aid pathways presents an opportunity to reimagine service delivery, enhance consumer engagement, and close longstanding gaps in access and outcomes. By embracing innovation while preserving the value of professional care, stakeholders can ensure that hearing healthcare in the OTC device era is both inclusive and impactful.

Conflict of Interest

None declared.

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Publication History

Article published online:
09 October 2025