Hearing Aid Market. Nikita Dikopoltsev: “The older generation is not ready to just bide their time”

- Nikita, your first center was opened in 2019 in Chelyabinsk. Today, 'SlyshuVizhu' centers operate in 12 cities, including Moscow. Clearly, your potential client base is huge. Could you describe your average patient and how the demand for your services has changed over time?

— Since hearing loss is most often age-related, our patients are primarily older adults, typically between 70 and 85 years old. For many, maintaining their hearing is essential to continue working, but the main request is the ability to communicate easily with family and relatives.

The penetration rate of hearing aids in Russia remains very low—only about 15% of people with hearing loss actually use them. The main barrier is strong stigmatization. To put it simply, people are embarrassed to wear hearing aids, much like people used to be embarrassed about wearing braces.

- The aging population is a pan-European trend. This trend is well recognized, which is why Moscow offers special programs that allow elderly residents to improve their quality of life and avoid feeling like a burden to their families. In most cases, you work with this same category of citizens. Do you cooperate with official government structures in this area?

— Work in this area is carried out mainly at the federal level. For people with hearing disabilities, compensation is provided for the purchase of rehabilitation equipment, including hearing aids. All of our centers operate under this program and accept such patients.

I would like to note specifically that the ability to hear well directly affects a person's social life. When a person stops communicating fully, they gradually withdraw into themselves, losing cognitive stimulation, social skills, and the simple joy of interaction.

At the same time, thanks to increasing life expectancy, older people today are not willing to accept this situation and simply 'live out their days.' Many of our patients lead highly active lifestyles—they work, travel, go skiing, and spend a lot of time with their families. Their schedules are sometimes busier than mine.

This is precisely what the silver age economy is all about, and it is set to become one of the main growth drivers for private medicine in the coming decades.

- Muscovites and St. Petersburg residents pay great attention to their health. How are things in the country’s regions regarding this matter (through the lens of your experience)?

— Private medicine in the regions is in demand, but severely limited by the availability of high-quality service. Awareness of modern technologies there is significantly lower: for example, about receiver-in-the-ear (RITE) devices or multi-channel fitting. Many people spend years wearing poorly adjusted old devices or still believe that ‘a hearing aid is a sign of old age’.

The main problem is the lack of a comprehensive approach: not just expert fitting of the device, but also the psychological preparation of the patient. This is a complex process that must be managed by the center's specialists, and there is not much of it in the regions yet.

Also, there are way more patients in Moscow who care about being able to hear at the theater.

- The modern generation prefers to spend most of their time wearing headphones. Doesn't this affect their hearing? Are you seeing a rise in young patients (aged 20–35) with hearing loss?

— Yes, this trend is well supported by both our medical practice and global statistics. We are indeed recording a noticeable increase in young patients. According to a study published in the Otolaryngology journal, by age 18, 12.9% of adolescents already show signs of noise-induced hearing damage, and 6.2% suffer from sensorineural hearing loss. The WHO predicts that by 2050, every second person on the planet will face hearing problems, partly due to portable audio devices.

Russian audiologists, including specialists at our centers, also note that the share of teenagers and young adults among patients is already reaching 30%. Unfortunately, the hair cells of the inner ear do not regenerate—the damage is irreversible. At the same time, young people often listen to music at levels of 100–115 dB, even though the safe threshold is only 85 dB. This significantly increases the risks.

- One of the articles on hearing loss stated that in 95% of cases, hearing degradation can be stopped or significantly slowed down with a hearing aid. Isn't this just a case of wishful thinking?

— The figure of 95% is not an exaggeration, but it must be interpreted correctly to avoid misleading people.

We are not talking about treating the ear or restoring damaged hair cells, but rather about compensation—meaning the technical capacity to help a person hear well and understand speech again. A hearing aid does not restore "natural" hearing, but it significantly improves communication skills. This is a medical fact.

As for stopping or slowing down age-related decline, the situation is more complex. In the case of sensorineural hearing loss, there is currently insufficient direct evidence that the device itself slows down cell death. However, its most critical task is to prevent the hearing areas of the brain from atrophying due to inactivity. In this sense, the effect is real.

When a person has poor hearing, they risk losing not only their hearing but also auditory perception—the brain's ability to correctly interpret sounds and speech. In this case, a hearing aid works like a trainer: it forces the brain to receive a full sound load, thereby helping to maintain the quality of auditory perception.

The figure of 95% itself comes from global statistics: between 90% and 95% of all hearing loss cases can be successfully corrected with modern digital devices. The only exception is total deafness, which requires cochlear implantation. Therefore, this is not "wishful thinking," but a realistic assessment of the capabilities of modern audiology.

- As an audiologist, you often find that a patient needs a complex, expensive hearing aid, but as an entrepreneur, you understand their ability to pay. How do you find the balance between 'perfect hearing' and the client's actual budget, ensuring you don't compromise their health, while also remaining profitable?

— Balance is built not on a compromise between quality and money, but on transparent communication and the proper organization of the selection process.

The main rule is that the budget should not dictate the quality of the fitting. As paradoxical as it may sound, the price of the device is far from always the deciding factor for success. According to our experience and European protocols, effective hearing aid fitting is rooted in deep diagnostics and individual customization, rather than the cost of the device.

If I see that a flagship, maximum-channel device would be optimal for a patient, but I recognize their financial constraints, I always explain the difference honestly. I use the patient’s audiogram to show which frequencies are affected the most, and explain exactly how a simpler model will underperform in noisy environments—like a restaurant, the subway, or out on the street. The top-tier model provides a much cleaner and more comfortable sound due to directional microphones and advanced noise reduction. At the same time, I never say that a budget device is useless—even that model offers massive progress compared to having no assistance at all.

At our centers, we help resolve payment issues by offering interest-free installment plans, assisting with electronic certificates for assistive technology (TSR), and working with government reimbursement programs.

For us, 'going into the negative' means fitting a device that the patient ends up not wearing. Therefore, when we select the best financial solution, even losing one 'high-ticket' sale pays off with the gratitude of a person who returns to us and brings their family and friends.

- Are there any restrictions on the development of the hearing care market in Russia?

— The key constraints today are an acute staff shortage and the lack of a generally accepted certification system. There is a shortage of qualified audiologists and hearing aid specialists. At the same time, some specialists who formally have the right to work lack a sufficient level of competence. This severely discredits the very idea of hearing care in the eyes of the public. Patients receive a poorly adjusted hearing aid, become disappointed, and postpone further treatment for years.

That is why we urgently need uniform certification standards and clear requirements for specialist training. Professionals should operate in the market, not companies with minimal qualifications. Without this, the industry will constantly face distrust, especially from elderly patients.

However, positive changes are already underway. Starting September 1, 2026, new requirements from the Ministry of Labor for hearing aid fitting organizations will come into effect. The main innovation is a mandatory registry of rehabilitation organizations. To get on this list and have the right to operate (including working under state contracts and electronic certificates), a company must verify four key parameters: qualified personnel, necessary equipment and capacity, a quality management system, and premises that meet all regulatory standards.

- Do online marketplaces that sell everything, including hearing aids, create any complications for your business?

— The uniqueness of our industry lies in the fact that we do not sell a hearing aid as the final product of our work. Our product is a comprehensive service: precise diagnostics, professional selection, individual adjustment, custom earmold fabrication, and lifelong patient support.

Without this full range of services, the device is essentially just a microchip in a plastic casing. This is exactly why hearing aids are barely in demand on marketplaces. Furthermore, in most cases, they are sold there without any warranty or maintenance service.

- The topic of import substitution is highly relevant for any business under current conditions. What equipment do you work with, and are there any difficulties? (How are things regarding maintenance and spare parts if it is foreign equipment?)

— The key difference of our centers is that we focus not just on selling devices, but on high-precision diagnostics and customized fitting using professional equipment. We follow the British audiological protocol, which is considered the gold standard in Europe.

In our centers, we utilize REM (Real Ear Measurement) equipment. This measuring system allows us to fit hearing aids based on the unique acoustics of each patient's ear canal, rather than relying on average data. Without REM fitting, even an expensive device can sound either too loud or muffled. 

We still source this equipment from Europe, though through more complex routes now. 

We have transitioned our maintenance services to our own facilities, having launched our own service center in 2026. Now, if any repairs are needed, they take only about two weeks.

* The photos provided by 'SlyshuVizhu' [HearSee] press service