The hearing instrument return rate in 2006, as suggested by data compiled by the Hearing Industries Association (HIA), continued to be lower than usual (15.6%) for the third consecutive year. Until the fourth quarter of 2003, return-for-credit rates hovered between 17% to 20% for more than a decade—and were often over 20% for programmable and digital hearing aids. The table below contrasts data from last year and from 5 years earlier in 2001, when digital aids were relatively new and constituted only 27% of the market (versus 92% in the first quarter of 2007). Return rates fell to 12.4% in 2004, moved upward to 17.0% in 2005, and then fell again to 15.6% in 2006. In the first quarter of 2007, the return rate was 14.9%. Possible explanations include:

  • Third-party payors and insurers may be covering more hearing aids. In the January 2004 HR, Miles Peterson, PhD, and Theodore Bell, PhD, showed that insured individuals are 5.4 times less likely to return their hearing aids.
  • Dispensing of the more problematic CIC-style hearing aid has been reduced in favor of styles like BTEs.
  • Reduced return rates may be due to better educated and skilled personnel who are using better performing digital aids that feature better first-fit algorithms.

On this last point, computer-aided fitting software and its implementation by dispensing professionals have improved incrementally, but significantly, over the past 15 years. The HR 2005 Dispenser Survey (June 2005 HR) showed that three quarters (76%) of all hearing aids dispensed are programmed using a dedicated computer and software, while 6% are programmed using a proprietary programming box; only about 18% are still programmed manually (eg, trimpots) or left to the manufacturer to program. The concepts behind digital aids are also more familiar. Compression kneepoints, attack/release times, and other advanced hearing aid features can still be confusing, but they’re no longer foreign concepts. Similarly, first-fit programs, non-linear fitting rationales (eg, NAL-NL1, DSL5, etc), and the continued development and identification of useful fitting and verification procedures have been refined, and all these tools greatly assist in using the full dynamic range of patients in multiple environments (including noise) while respecting UCLs.

Whatever the reason for the decrease in return-for-credit rates, it comes as terrific news for the industry and consumers. As Robert Sweetow, PhD, and colleagues pointed out in their January 2004 HR article, “A Time-Cost Analysis with Patients Who Purchase, Return, and Exchange Hearing Aids“, the amount of time a clinician spends on patients who keep versus patients who return their hearing aids is essentially the same. Therefore, there is no such thing as a “free hearing aid” because someone ultimately pays for the products and services: “Patients keeping their hearing aids are subsidizing the patients who either return or exchange devices.”

If the return for credit rate has indeed fallen permanently from the historic levels of 17% to 20%, it represents exceptional savings in time and costs at all levels—manufacturing, dispensing, and most importantly, the consumer.

Karl Strom
[email protected]