Deborah Tolu-Kolawole
The National Health Insurance Authority has adopted Health Technology Assessment to guide healthcare spending and help ensure that limited resources are directed towards interventions that provide greater value to Nigerians.
The Director-General of the NHIA, Dr Kelechi Ohiri, disclosed this in a presentation titled “Progress of Health Technology Assessment Institutionalisation in Nigeria” at the Inauguration of the HTA Steering Committee and Official Flag Off of HTA in Nigeria on Wednesday.
The event was officially flagged off by the Coordinating Minister of Health and Social Welfare, Prof Muhammad Ali Pate.
Ohiri said the institutionalisation of HTA would strengthen evidence-based decisions on healthcare coverage, reimbursement, pricing and resource allocation as Nigeria works towards Universal Health Coverage.
According to the presentation, “HTA provides the evidence-based methodology to ensure those resources are spent efficiently and equitably.”
He explained that HTA was not being developed as a standalone technical programme but as part of the broader reforms to strengthen the NHIA’s strategic purchasing function.
The presentation stated, “Strategic purchasing requires deliberate decisions about what healthcare to purchase, for whom, from whom, at what price and on the basis of what evidence.”
Ohiri said such evidence had become increasingly important as health insurance coverage expands and the range and cost of health technologies increase.
“HTA provides a systematic and multidisciplinary approach to assessing the clinical, economic and wider value of health technologies,” he said.
According to him, the approach would strengthen decisions on benefit package design, coverage, reimbursement, adoption, pricing and resource allocation.
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.
Since then, the Authority has developed an HTA Framework, Reference Case, Process Guidelines, Deliberative Process, Committee Terms of Reference, Conflict of Interest Policy and Stakeholder Mapping and Analysis.
The presentation said the documents provide the governance architecture and operational guidance required to move HTA from an emerging technical activity to a consistent institutional process.
The Authority has also invested in local capacity, with two PhD students and two Master’s students receiving postgraduate HTA training at Mahidol University in Bangkok, Thailand.
The NHIA also conducted and published the Nigerian EQ-5D-5L valuation study to generate locally relevant evidence for calculating Quality-Adjusted Life Years.
The presentation stated, “This is an important component of institutionalisation because HTA should not rely solely on evidence and preferences generated in other settings when locally relevant evidence can be developed.”
To test its framework, the NHIA commissioned and completed 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 involved a rapid evaluation of clinical and economic evidence for advanced liver cancer.
A major milestone came in October 2025 when the Coordinating Minister approved the National HTA, followed by approval of the HTA Steering Committee.
The inauguration and official flag-off on Wednesday mark a transition from developing the NHIA’s internal HTA capacity and testing its methodologies to establishing a coordinated national HTA system.
The Steering Committee is expected to provide strategic oversight and guidance, support transparent prioritisation of HTA topics, strengthen methodological quality and conflict-of-interest safeguards, and promote stakeholder and citizen engagement.
It will also support capacity development, the use of Nigerian evidence and stronger pathways through which HTA findings can inform health policy, benefit packages, strategic purchasing and reimbursement decisions.
The development comes amid broader health financing reforms aimed at expanding health insurance coverage, improving financial protection and ensuring more efficient use of available healthcare resources.
The National Health Financing Policy Dialogue, held from September 1 to 4, 2025, under the theme “Reimagining the Future of Health Financing in Nigeria,” brought together government, policymakers, development partners, civil society, academia and the private sector to discuss sustainable and equitable health financing.
HTA featured in the dialogue as a tool for evidence-informed priority-setting and more effective use of scarce resources.
The NHIA presentation, however, noted that the 2025 dialogue did not create the Authority’s HTA initiative but formed part of the wider health financing reform environment within which the institutionalisation process progressed.
The Authority said the ultimate measure of HTA institutionalisation would be its impact on healthcare resource decisions.
“Institutionalisation should ultimately be judged not by the number of assessments produced, but by whether HTA improves the decisions made about healthcare resources,” the presentation stated.
It added that the goal was for “evidence to become a routine input into priority-setting and strategic purchasing”, while making benefit-package and coverage decisions more systematic and transparent.
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