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FDA Proposes New Rule for Over-The-Counter Hearing Aids

Oct. 19, 2021 — The FDA issued a long-awaited proposal Tuesday that would offer a new category of affordable over-the-counter hearing aids for nearly 30 million Americans who report mild or moderate hearing loss.

The action comes nearly 5 years after Congress passed a law to allow over-the-counter sales for people with mild to moderate hearing loss.

Those with severe hearing loss or people under 18 years old would still need to see a doctor or specialist for a hearing device.

In the United States, access to hearing aids can be difficult and expensive.

Usually, you have to go see your doctor for a prescription. Then, you go to an audiologist, or a hearing aid specialist, to get the device fitted to your ear.

With the proposed rule, you could skip both of those steps and buy hearing aids in retail stores or online. This would make the process easier and more cost-friendly, as well increase access to specialists for many Americans who don’t have it.

“This allows us to put hearing devices more in reach of communities that have often been left out. Communities of color and the underserved typically and traditionally lacked access to hearing aids,” Xavier Becerra, secretary of the U.S. Department of Health and Human Services, said at a news briefing.

How Do Hearing Aids Work?Ever wondered how hearing aids actually improve your listening skills? 87

Hearing aids are

small, electronic devices that

amplify sound.

While they can’t restore normal

hearing, hearing aids can help

you hear better by making

certain sounds louder in both

quiet and noisy situations.

Hearing aids come in several

styles that fit

in or on your ear in different

ways, including “behind

the ear,” “in the ear,” “in

the canal,” and “completely

in the canal.”

While the style may vary,

all hearing aids have

the same basic parts:

a microphone, amplifier,

speaker, and battery.

Here’s how they work:

First, the microphone picks up

sounds from the environment.

Then, a computer chip

with an amplifier

converts the sound waves

into electrical signals.

It analyzes and adjusts

the sounds based on your hearing

loss and the level

of other sounds around you.

These amplified signals are then

converted back into sound waves

and delivered to your ear

through the speaker.

In this way, hearing aids

can improve your hearing

and speech comprehension

if your hearing loss is caused

by damage to the sensory cells

in your inner ear.

The greater the damage

to these cells, the more severe

your hearing loss will be,

and the more amplification

you will need from a hearing aid

in order to compensate.

If you think you might have

a hearing loss

and could benefit from using

hearing aids,

talk to your doctor

or audiologist

for more information.

National Institute on Deafness and Other Communication Disorders: “Hearing Aids.”
American Speech-Language-Hearing Association: “Learning About Hearing Aids.”
Mayo Clinic: “Hearing Aids: How to Choose the Right One.”
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The FDA says it’s unclear exactly when the new products will be in stores, but finalizing the ruling is a top priority.

For new products, the ruling is expected to go into effect 60 days after it is finalized. Current products would have 180 days to make changes, according to the FDA.

The American Academy of Audiology said in a statement that it is reviewing the proposed rules and will provide comments to the FDA. But in July, Angela Shoup, PhD, a professor at the School of Behavioral and Brain Sciences at the University of Texas at Dallas, wrote to Becerra with concerns about over-the-counter sales of hearing aids.

“While we certainly support efforts to lower costs and improve access to hearing aids, we have grave concerns about the oversimplification of hearing loss and treatment in the advancement of OTC devices,” she wrote.

“It is through involvement of an audiologist that consumers will achieve the best possible outcomes with OTC hearing aids and avoid the risks of under- or untreated hearing loss,” Shoup said.

This new category would apply to certain air conduction hearing aids, which are worn inside of your ear and improve your hearing by boosting sound into your ear canal.

The FDA is also proposing labeling requirements for the hearing devices, including warnings, age restrictions, and information on severe hearing loss and other medical conditions that would prompt you to seek treatment from a doctor.

The FDA said that it would closely monitor the marketplace to make sure companies advertising hearing loss products follow federal regulations.

There are a number of reasons for hearing loss, including exposure to extremely loud noises, aging, and various medical conditions.

Around 38 million Americans 18 years old and older report having hearing trouble, says Janet Woodcock, MD, acting commissioner of the FDA.

But she says only about 20% of people who could benefit from hearing aids are using them, with barriers to access being a major factor.

“Hearing loss can have a profound impact on daily communication, social interaction, and overall health and quality of life for millions of Americans,” Woodcock says.

The FDA has also updated its guidance on hearing devices and personal sound amplification products.

Personal sound amplification products (PSAPs) are nonmedical devices designed to amplify sounds for people with normal hearing and are usually used for activities like bird-watching and hunting.

Amplification devices are not regulated by the FDA.

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