Product Narrative: Hearing Aids

Table of Contents

• ACKNOWLEDGEMENTS
• ACRONYMS
• EXECUTIVE SUMMARY
• INTRODUCTION
  • 1. Assistive Technology and Market Shaping
  • 2. Product Narrative
• CHAPTER 1: MARKET LANDSCAPE
  • 3. Market Context
    • 3.1. Globally 466 million people have disabling hearing loss; this number is expected to double by 2050 due to ageing populations, and new cases of hearing loss caused by untreated ear infections, ototoxicity, and noise exposure.
    • 3.2. W.H.O. estimates that 72 million people worldwide need hearing aids, but current coverage of hearing aids meets less than 3% of need in L.M.I.C.s.16
    • 3.3. Unaddressed hearing loss has a profound effect on individuals, and hearing aids can assist to counteract negative effects.
    • 3.4. Experts recommend that hearing aids should be provided within the context of a broader Ear and Hearing Care programme, but multiple implementation challenges exist.
    • 3.5. Provision of hearing aids generally includes the following steps: 1) screening for and diagnosing hearing loss; 2) selecting and fitting appropriate hearing aids; and 3) providing long-term follow-up and rehabilitation services to the user.
    • 3.6. W.H.O. global guidelines related to hearing aid provision in low-resource settings (L.R.S.) are outdated and lack specificity, which has led to a variety of approaches to hearing aid provision.
    • 3.7. While different types of hearing aids exist in the market, specific hearing aids appropriate for the L.M.I.C. context are described by the W.H.O. P.P.P..
    • 3.8. No global standard for quality testing currently exists to differentiate quality hearing aids from poor quality products.
    • 3.9. Donor funding for procurement and provision of hearing aids in L.M.I.C.s is limited and often comes from C.S.R. programmes of leading suppliers.
  • 4. Market Assessment
    • 4.1. The global hearing aids market focuses on high-income markets and is consolidated around five major manufacturers who control the value chain.
    • 4.2. The Big 5 are focused on premium products to generate market value and have limited commercial interest in L.M.I.C.s.
    • 4.3. To meet the needs of lower-income market segments, approaches exist in the private sector that can deliver quality hearing aids in more affordable ways to the end-user.
    • 4.4. In the absence of a global standard, quality products struggle to compete in unregulated markets as many low-cost suppliers have emerged that have products of variable or unknown quality.
    • 4.5. National health insurance systems in H.I.C.s have been able to increase adoption rates, sustainably deliver services and reduce prices obtained on Big 5 models through volume-based negotiation.
    • 4.6. While there is potential to increase adoption of affordable and quality hearing aids, there is currently a considerable lack of effective public procurement in L.M.I.C.s.
    • 4.7. N.G.O.s have found ways to access quality hearing aids at an affordable rate and provide cost-effective services, pointing to potential approaches that L.M.I.C. governments could use to access affordable, quality products.
    • 4.8. There is limited scope to optimise or relocate manufacturing to generate additional cost reductions in the price of hearing aids.
    • 4.9. The advent of new technologies for hearing loss screening and diagnosis and hearing aid fitting may address service delivery capacity constraints and create opportunities to reach more people.
    • 4.10. Innovative models of hearing aids have the potential to facilitate greater access to hearing aids in L.M.I.C.s.
  • 5. Market Challenges
• CHAPTER 2: STRATEGIC APPROACH TO MARKET SHAPING
  • 6. Strategic Approach to Market Shaping
    • Strategic Objective 1: Strengthen global policy guidance around service delivery, product selection and product quality
    • Strategic Objective 2: Support L.M.I.C. governments to strengthen hearing aid provision including demand generation and investing in service delivery capacity, government purchasing and procurement support
    • Strategic Objective 3: Engage the private sector to expand delivery of affordable, quality hearing aids and related services
    • Strategic Objective 4: Work with suppliers to enter L.M.I.C. markets with affordable, quality hearing aids
    • Strategic Objective 5: Spur innovation to support simplified provision models and introduction of optimal products
  • 7. Next Steps
• APPENDICES
  • APPENDIX A: INDIVIDUALS INTERVIEWED OR CONSULTED
  • APPENDIX B: PROVISION OF E.H.C. SERVICES ACROSS DIFFERENT HEALTHCARE LEVELS IN L.M.I.C.S (BASED ON EXPERT INTERVIEWS)84, 85
  • APPENDIX C: HEARING AID FITTING PROCESS
  • APPENDIX D: SUMMARY OF W.H.O. PREFERRED PROFILE FOR HEARING AID TECHNOLOGY SUITABLE FOR L.M.I.C.S93
• Notes