Funding for and Access to Hearing Aids in Europe: A Comparison among France, England, Belgium, and Sweden

QES n° 293
2024/10

ABSTRACT
Funding for and access to hearing aids were compared across four European countries. In France and Belgium, purchases are mainly private, whereas in Sweden and England, the public sector manages centralised purchases via a system of calls for tenders with free or almost free distribution to the users. The reform entitled '100% Santé en Audiologie' ('100% Healthcare for Hearing Aids') in France provides a broad range of hearing aids that are accessible without out-of-pocket payments for the patient owing to funding by the public insurance scheme and complementary healthcare schemes, and the existence of a capped purchase price. In Sweden, all the ranges are available in the public system, and the patient contribution is zero or insignificant, but the disadvantages of the system are limited supplies and waiting lists. In England, the National Health Service (NHS) provides free access to a limited supply of hearing aids at a relatively low cost for the NHS, without public complementary coverage for the private market. Belgium has opted for funding equivalent to that of France, but it is based solely on public insurance. This system, with no price regulation and with a high level of coverage, appears to provoke an inflationist situation with regard to sale prices, which results in higher out-of-pockets payments from patients than those observed in France.
Since the reform, which has resulted in a significant improvement in access to hearing aids, France has been in a better position than the other countries studied. A number of issues for the future have been identified: avoiding a situation in which ‘no charge’ for the user leads to expensive commercial practices for communities, managing the available basket of hearing aids without out-of-pockets for patients while integrating technical progress, and ensuring that the complementary insurance premiums of elderly persons remain financially accessible.

See also Questions d'économie de la santé n° 293 in French: Financement et accès aux aides auditives en Europe : une comparaison entre la France, l'Angleterre, la Belgique et la Suède.