Lyric is a dramatic departure from traditional hearing aids and represents a “disruptive technology” both in terms of the actual device design and function, as well as for the potential for practice growth.

Lyric is a 24/7 hearing device that is unique not only in terms of its features and how it is fit, but also in terms of practice economics. Technical and performance characteristics,1 as well as candidacy and fitting protocols2 for the device, were presented in previous editions of HR. The present article discusses the business growth opportunities that Lyric provides for hearing care practices.

From a business perspective, Lyric may benefit a practice in four key ways:

  • Attracting new patients;
  • Increasing referrals from current patients;
  • Producing recurring revenue; and
  • Increasing face time with patients leading to a stronger connection between clinician and patient.
Figure 1
FIGURE 1. Percent of patients making appointments due to interest in Lyric who are new to the practice (blue) and new to amplification (magenta).

New Patients Walk in the Door

The entire Lyric device sits deeply in the ear canal, making it completely invisible. While the deep-canal design was motivated primarily by the acoustic advantages it provides, invisibility is a compelling benefit that motivates many individuals to finally consider using amplification. Lyric is also the only hearing device on the market that remains in the ear canal continuously for up to 4 months at a time, making it free of daily hassles. There is no daily maintenance required, such as changing batteries or cleaning the device, and daily insertion and removal are not required.

Because Lyric addresses these core patient needs, offering Lyric can bring new patients into the office. Data collected from three practices that offer Lyric reveal that approximately three-quarters of the people who come to the office interested in Lyric are new to the practice and about half are new to amplification (Figure 1).

Currently, approximately 50% of individuals interested in Lyric will be contraindicated due to ear size. A new, smaller device is scheduled to be available in 2011 which should reduce contraindication rates significantly. Today, the contraindication of an individual creates a perfect opportunity to present other amplification solutions to the patient. The flow chart in Figure 2 illustrates how this worked at one practice offering Lyric.

Figure 2

FIGURE 2. Purchase map highlighting purchase results from Lyric patient appointments for a Lyric provider. THA = Traditional Hearing Aid.

Happy Patient Referrals

Referrals drive many new patients to a practice. Patients who are happy with both the level of service they receive from an office and the quality of the product they purchase are more likely to recommend the practice and product to an acquaintance, friend, or family member who may need a hearing device.

Lyric satisfaction is very high. In consumer surveys from 30 different Lyric offices around the country, at 1 month or more after initial fitting, 91% of individuals surveyed were very satisfied with Lyric (n=112). A total of 92% expected to purchase Lyric subscriptions again (n=112) and 96% would recommend Lyric to a loved one (n=90).

Tanya L. Arbogast, ScD This article was submitted to HR by Tanya L. Arbogast, ScD, a research audiologist at InSound Medical Inc, Newark, Calif. Correspondence can be addressed to HR or

The Net Promoter Score3 is a metric developed by Harvard Business School and Bain & Company to measure customer loyalty and estimate the potential for future growth of a product. Lyric wearers were asked, “On a scale of 0 to 10, how likely are you to recommend Lyric to friends and colleagues?” An individual responding 0 to 6 is considered a detractor, 7 to 8 is neutral, and 9 to 10 is a promoter. The promoter score is the percentage of promoters minus the percentage of detractors (% promoters – % detractors), so the score can range from -100% (all detractors) to +100% (all promoters). Most companies’ scores hover around a 10% net promoter score. Some of the lowest, like health insurance, average in the negatives (-13%). Lyric scored 61% (n=124), which is similar to companies like Google (63%) and eBay (64%) that are considered by many to be leaders in innovation, loyalty, and consumer opinion.3 Lyric’s net promoter score is at a level almost unheard of in the health care industry and poses a unique opportunity for providers to deliver a technology that exceeds patient expectations.

Patient Loyalty

Because Lyric is replaced about 3 to 6 times a year during brief re-fit appointments, the clinician-patient relationship may be stronger than in the case of a traditional hearing aid where patient visits are less frequent and/or sporadic (if they are more frequent, it is usually due to a problem). This increase in the frequency of clinician-patient face-to-face interaction may strengthen the relationship between the practice and the patient and thus promotes loyalty to the practice.

Figure 3
FIGURE 3. Number of total units sold (both Lyric and other hearing aids) as a function of year, for a practice that offers Lyric.
Figure 4
FIGURE 4. Number of units sold (traditional hearing aids, new Lyric subscriptions, and Lyric renewals) as a function of year for another practice.

Recurring Revenue

Lyric is sold almost exclusively on a subscription basis. This purchase model has two benefits. One benefit is for the patient who might be hesitant about purchasing a technology that may be outdated in a couple of years. With Lyric, the patient can purchase 1 year, and then has the freedom to make another decision at the end of that year: stay with Lyric or choose another device. This allows the patient to feel more in control and more confident about their purchase.

The other benefit of the Lyric subscription model is recurring revenue. Recurring revenue is a new concept in the hearing industry. When a satisfied Lyric wearer renews his subscription after 1 year, the practice generally receives the same payment for the year’s subscription, but without much of the work involved in a new hearing aid fitting. The resubscribed patient is simply re-fit with the latest version of Lyric technology during a standard 10-minute re-fit appointment. If the patient desires to purchase a 2- or 3-year subscription, these options are also available, thus locking in revenue for the office.

Figures 3 and 4 illustrate how quickly units sold may increase with recurring revenue. These figures show data from two different practices that offer Lyric. Both began offering Lyric in 2007. Figure 3 shows total units sold (Lyric and other hearing aid sales), while Figure 4 breaks it down by regular hearing aids, new Lyric subscriptions, and Lyric renewals.

Table 1 summarizes the data for these two practices in terms of percent growth relative to the previous year. For comparison, hearing aid sales growth (as reported by HIA) is included. It can be seen that both practices dramatically increased their sales by adding Lyric to their offerings.

Table 1
TABLE 1. Percent increase in unit sales relative to the previous year, as reported by HIA and two Lyric practices.


Lyric is a dramatic departure from traditional hearing aids and represents a disruptive technology both in terms of the actual device design and function, as well as for the potential for practice growth. Lyric may bring to the practice new patients, as well as patients who have never worn amplification before. Wearers are generally happy with their experience and tend to send their friends and loved ones to the same practice. Replacement visits several times a year foster the relationship between clinician and patient, building loyalty to the practice, and the Lyric subscription model financially benefits both the patient and the practitioner.


  1. Arbogast TL, Whichard S. A new hearing aid class: the first 100% invisible, extended-wear hearing aid. Hearing Review. 2009;16(4):20-26.
  2. Arbogast TL. Candidacy and fitting protocols for a 24/7 hearing device. Hearing Review. 2010;17(9):34-37.
  3. 2010 net promoter industry benchmarks. San Mateo, Calif: Satmetrix. Available at: Accessed September 20, 2010.

Citation for this article:

Arbogast TL. The economics of a 24/7 hearing aid. Hearing Review. 2010;17(11):42-46.