The National Health Insurance Authority (NHIA) has begun moves to institutionalise Health Technology Assessment (HTA) as part of efforts to ensure that scarce healthcare resources are deployed efficiently, equitably and based on evidence.

To this end, the Federal Government has inaugurated a Steering Committee on National Health Technology Assessment to evaluate the clinical, social, economic, organisational and ethical implications of health interventions and technologies and guide policy decisions.

Speaking at the inauguration in Abuja, Director-General of NHIA, Dr Kelechi Ohiri, said the initiative marked a significant step in a process that began more than two years ago to strengthen evidence-based decisions on healthcare coverage and purchasing.

He said HTA would provide a systematic basis for determining which health services and technologies should be prioritised, who should receive them, where they should be purchased and what government and other purchasers should pay. “Our health needs are plenty, and the resources are limited,” Ohiri said, stressing the need for evidence to guide spending.

According to him, HTA would strengthen decisions on benefit-package design, coverage, reimbursement, pricing and resource allocation as Nigeria pursues Universal Health Coverage (UHC). He said the initiative formed part of broader reforms to strengthen NHIA’s strategic purchasing function.

The authority established a Strategic Purchasing Department and a dedicated HTA Division in 2025. It has since developed an HTA Framework, Reference Case, Process Guidelines, Deliberative Process, Committee Terms of Reference, Conflict of Interest Policy, and Stakeholder Mapping and Analysis.

NHIA has also invested in local capacity, with two PhD and two master’s students receiving postgraduate HTA training at Mahidol University, Bangkok, Thailand. It also conducted and published the Nigerian EQ-5D-5L valuation study to generate local evidence for calculating quality-adjusted life years.

To test the framework, the authority completed pilot assessments on kidney replacement therapy, colorectal cancer screening and sorafenib for advanced liver cancer. The studies examined the cost-effectiveness and clinical and economic value of the interventions.

Under the National Health Insurance Authority Act 2022, HTA recommendations are expected to inform the design and refinement of the national health benefits package and guide the optimisation of limited health budgets.

Speaking at the event, Minister of Health and Social Welfare, Prof. Muhammad Pate, said Nigeria could no longer make healthcare investment decisions by simply copying countries with different resources and health needs.

He said the country had been without a home-grown, evidence-based system for deciding which treatments and interventions should receive public funding. Pate said the framework would assess medicines, diagnostics, medical devices, procedures and other interventions based on clinical effectiveness, safety, affordability, cost-effectiveness and equity.

He noted that Nigeria’s double burden of communicable and non-communicable diseases, coupled with population growth and ageing, made systematic and transparent healthcare spending decisions increasingly important.

The minister stressed that HTA should not be viewed merely as a cost-cutting mechanism or a means of restricting access to life-saving treatments. “It’s not also just about reducing healthcare expenditure or restricting access to important life-saving tools,” he said, adding that the objective was to direct scarce resources towards interventions that deliver meaningful health benefits and value for money.

Pate said HTA evidence would also support NHIA’s expanding health insurance programme, particularly in designing benefit packages and making coverage and purchasing decisions. He challenged the committee to ensure that HTA does not become another repository of reports with little impact on government policy, stressing that its success should ultimately be measured by whether the evidence influences what Nigeria finances, purchases and provides to citizens.

The framework is also expected to guide financial protection for Nigerians facing costly illnesses. Pate cited plans for a catastrophic health insurance fund covering conditions including kidney disease, cancers and spine surgery, noting that HTA evidence would be critical to determining how such resources are deployed.

He further stressed that the system must ensure that poorer and marginalised Nigerians are not excluded from healthcare because of treatment costs.