How Apple just changed hearing aids forever - and the lives of those who need them

Jada Jones/ZDNET

Yesterday, Apple announced that the next software update for AirPods Pro 2 will include an interactive hearing test that, once completed, will turn the device into a fully functional hearing aid. 

Also: Your AirPods Pro 2 can soon double as OTC hearing aids. Here's how

In this article, we'll discuss the disruption to the moribund old-school hearing aid business as well as the new over-the-counter hearing aid market that's been active for the past two years. It's seismic!

The United States Food & Drug Administration, the governing body that regulates hearing aids, reports that close to 30 million adults here in the US have hearing loss. More than half of adults over 60 have some disabling hearing loss.

The health costs of this are profound. Beyond the obvious communication challenges, those with hearing loss often suffer from depression and substantial cognitive decline. Those with hearing aids often suffer because the devices are uncomfortable, but they also have a stigma that sometimes causes sufferers to be unwilling to wear hearing aids.

Also: The 4 biggest new health features Apple just announced

Hearing aids are devices that fit behind the ear, in the ear, or even in the ear canal. Generally speaking, they pick up sound via a microphone, amplify it, and then provide the amplified sound to the user.

Up until 2022, access to hearing aids was very tightly controlled. Patients had to go to an audiologist, otolaryngologist, or audiometrist to get a hearing aid prescription, and then had to purchase hearing aids from a small group of companies that make them.

The entire process was extremely costly, ranging from a few thousand dollars up to tens of thousands of dollars. Worse, many insurance companies didn't cover or didn't fully cover medical devices, so it was up to the person with hearing loss to foot the bill for aid. According to the FDA, only one out of five people who could benefit from hearing aids had access to them.

Also: The iPhone 16 is undeniably great hardware - but you should still probably skip it

On August 17, 2022, that closed ecosystem was cracked open when the FDA established a regulatory category for over-the-counter (OTC) hearing aids. This was made possible by H.R.2430, a reauthorization act introduced by Representative Joe Kennedy III and Senator Elizabeth Warren. The act was passed by the 115th Congress and mandated that the FDA permit OTC hearing aids. According to a Johns Hopkins report, the change in law was expected to drop the cost of hearing aids by as much as 90%.

Amazon now lists hearing aids ranging in price from $49.99 up to more than $2,000. Obviously, there's going to be a wide range of quality and usability given that price span.

It's also important to realize that while OTC hearing aids may help a wide swath of people with reduced hearing, those with the most serious challenges will still benefit from custom analysis, recommendation, and fittings that only a licensed professional can provide. Additionally, cochlear implants and bone-anchored implants are surgically implanted for people with profound hearing loss.

Also: I went hands-on with Apple's standard iPhone 16 and didn't envy the Pro models at all

Prior to 2017, the hearing aid market was dominated by six hearing aid providers (known as the big six). According to The Hearing Review, 3.65 million hearing aids were dispensed in the United States in 2016.

According to Fortune Business Insights, the hearing aid market is expected to grow from $4.94 billion in 2024 to $11.54 billion by 2032. Although Apple doesn't release individual device revenue numbers, Acumen Financial estimates that Apple's AirPods business alone generated $23 billion in 2020.

In other words, Apple's AirPods market exceeds the entire hearing aid market by a fairly substantial ratio. Apple also dominates the headphone market overall. Data from 2021 (which is the most recent I could find) showed that Apple (including Beats) had almost 50% market share, with the rest being fought out by Bose, Samsung, JBL, Sony, and others. AirPods have gotten even more popular since 2021, so it's fair to assume Apple pretty much owns this market.

Also: iPhone 16 Pro vs. iPhone 14 Pro: Is it worth an upgrade?

Now that Apple has announced that its $249 AirPods Pro 2 will support a home hearing test and can be configured as a "clinical-grade" hearing aid, you can feel a seismic shift in the overall market.

ZDNET's Jada Jones has the details about when you'll be able to download and use this new capability in the currently-available AirPods Pro 2.

With one estimate claiming that Apple shipped 28.4 million AirPods Pro 2 in Q4 2022, we can make some rough predictions of how many hearing aid-capable AirPods Pro 2 are in the wild. It's been eight quarters since the AirPods Pro 2 shipped in September 2022. If AirPods Pro 2 shipments held to roughly the same numbers they did in 2022, there are probably about 200 million AirPods Pro 2 out there in consumer hands, ready to become hearing aids when the update hits.

So do the math. Roughly 30 million Americans in the US have hearing loss and only about six million have assistive hearing devices. However, 200 million people worldwide are currently in possession of a device that can soon function as a clinical-grade hearing aid. It begs the question: how many untreated individuals already have a device they can use as a hearing aid, given 200 million AirPods Pro 2 currently out in the wild?

Also: The 7 best iOS 18 features that will make updating your iPhone worthwhile

Let's think about this for a moment:

Prior to 2022, only a small fraction of those with hearing loss had access to very expensive hearing aids. However, those aids were prescribed by licensed professionals and presumably, the devices thus prescribed provided aid to their users.After 2022, the hearing aid market became a fairly unregulated bazaar. Consumers could buy super-cheap hearing aids, but you get what you pay for. Whether they did the job was completely hit or miss.Also, after 2022, some patients still went to licensed professionals for professional treatment. But this market was undoubtedly even smaller than it had been prior to the FDA reauthorization act.

But now, Apple is adding a clinical feature to its $249 device that's already in hundreds of millions of ears. With the AI-powered hearing test and the ability to tune the hearing aid functionality with the assistance of machine learning, consumers may have the best of both worlds: physician-free hearing assistance, along with appropriate tuning and configuration for most ears.

Also: The best earbuds of 2024: Expert tested and reviewed

Plus, rather than the stigma of an over-the-ear hearing aid, AirPods users are seen as AirPods users, not people with hearing loss. This might encourage those who otherwise wouldn't wear assistive hearing devices due to stigma to use AirPods stealthily as assistive devices.

I'm sure we'll continue to see Amazon flooded with cheap headphones listed as hearing aids. But with an official clinical-grade device from Apple, many with moderate hearing loss will now have a go-to device that could make a profound difference.

One final note: don't take any of this as medical advice. If you have medical questions about your hearing, go see your doctor. In fact, go see your doctor anyway. 

What do you think about this Apple news? Do you think that on-device hearing aids in the AirPods Pro 2 will be disruptive to the existing hearing aid market? Let us know in the comments below.

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