If used in a small device like a hearing aid, a 2x factor can have a significant impact on battery life.

VoIP in general experiences full packet loss, meaing if a single bit flips the entire packet is dropped. For radio links like Bluetooth it's possible to deal with some bit flips without throwing the entire packat away.

Until 1.5 Opus PLC was in my opinion it's biggest weakness, compared to other speech codecs like G.711 or G.722. A high compression ratio causes bit flips to be much more destructive.

As for making moeny, Bluetooth codecs have no license fees.