Nigeria Health Technology Assessment: NHIA Inaugurates Steering Committee

Nigeria health technology assessment took a major step toward becoming institutionalised this week, as the National Health Insurance Authority (NHIA) inaugurated a steering committee to make evidence the basis of healthcare spending decisions. The committee, launched on Wednesday in Abuja, will evaluate the social, economic, organisational and ethical issues raised by health technologies and feed those findings into policy.

The goal is to turn health technology assessment into a transparent, evidence-based priority-setting instrument for achieving universal health coverage. In practice, that means guidance on which services and technologies to prioritise, who should receive them, where they are purchased, and what government and other purchasers should pay for them.

Speaking at the inauguration, NHIA Director-General Dr Kelechi Ohiri described the move as a significant step in a journey that began more than two years ago and is designed to help the country make better decisions on healthcare coverage and purchasing.

A framework for strategic purchasing

Ohiri stressed that HTA is not being built as a standalone technical programme. It sits inside the broader reforms to strengthen the NHIA’s strategic purchasing function. “Strategic purchasing requires deliberate decisions about what healthcare to purchase, for whom, from whom, at what price and on the basis of what evidence,” he said.

That evidence matters more as insurance coverage expands and the range and cost of health technologies grows. “HTA provides a systematic and multidisciplinary approach to assessing the clinical, economic and wider value of health technologies,” Ohiri said. That approach, he added, would strengthen decisions on benefit package design, coverage, reimbursement, adoption, pricing and resource allocation.

Beyond cutting costs

Minister of Health Prof Muhammad Ali Pate cautioned that the exercise must go beyond reducing expenditure. “It’s not just about reducing healthcare expenditure or restricting access to important life-saving tools,” he said. The objective, he argued, is to direct scarce resources toward interventions that deliver real health benefits and value for money.

Pate said Nigeria has been “flying blind” without a home-grown, evidence-based system for deciding which treatments and interventions should receive public funding. The country, he noted, has often adopted approaches from nations with very different resource bases and value systems without generating enough evidence for its own circumstances.

Nigeria faces a double burden of disease, with communicable diseases still posing major challenges while non-communicable conditions such as cancer, kidney disease and other chronic illnesses rise. The problem will grow more pressing as the population ages and demand for healthcare expands, Pate said.

Nigeria health technology assessment: from pilots to a national framework

The NHIA began strengthening its HTA capacity as part of its strategic purchasing reforms, establishing a Strategic Purchasing Department and a dedicated HTA Division in 2025. It has since developed an HTA Framework, Reference Case, Process Guidelines, a Deliberative Process, Committee Terms of Reference, a Conflict of Interest Policy and Stakeholder Mapping and Analysis.

To test the framework, the authority commissioned three pilot HTA assessments covering kidney replacement therapy, colorectal cancer screening and sorafenib for advanced liver cancer. The kidney replacement therapy assessment examined the cost-utility of dialysis and kidney transplantation, while the colorectal cancer study assessed alternative screening strategies. The sorafenib assessment was a rapid evaluation of clinical and economic evidence for advanced liver cancer.

Building local evidence

The authority has also invested in local capacity, funding two PhD students and two master’s students for postgraduate HTA training at Mahidol University in Bangkok, Thailand. It published the Nigerian EQ-5D-5L valuation study to generate locally relevant evidence for calculating quality-adjusted life years. As the NHIA’s presentation put it, HTA “should not rely solely on evidence and preferences generated in other settings when locally relevant evidence can be developed.”

A major milestone came in October 2025, when the Coordinating Minister approved the National HTA, followed by approval of the HTA Steering Committee. Under the NHIA Act of 2022, HTA recommendations are meant to inform the design and refinement of the national health benefits package and BMPHS, so that limited health budgets are optimised for the best population health outcomes.

Equity and financial protection

Pate said the framework should also support decisions on financial protection for Nigerians facing costly illness. He pointed to efforts to establish a catastrophic health insurance fund covering conditions including kidney disease, cancers and spine surgery, and noted that HTA evidence would increasingly guide how those resources are deployed. The new system, he said, must also make sure poorer and marginalised Nigerians are not excluded from care because of the cost of treatment.

The minister acknowledged that HTA will inevitably trigger difficult public debates, particularly over expensive treatments that may extend life but place heavy demands on limited resources. The ultimate test, he said, will be whether the evidence changes decisions on what Nigeria finances, purchases and provides to citizens.

Ohiri put the case plainly: “Our health needs are plenty, and the resources are limited.” The value of HTA, in his framing, is better evidence about what should be bought with the funds available.

Source: The Guardian Nigeria