Nigeria's Federal Government Launches HTA Initiative for Efficient Health Resource Use

The National Health Insurance Authority (NHIA) has introduced a new approach, Health Technology Assessment (HTA), to guide its healthcare expenditures. This move aims to ensure that the nation's limited financial resources are channeled towards interventions that offer significant value to citizens.

Dr. Kelechi Ohiri, the Director-General of the NHIA, made this announcement during his presentation titled “Progress of Health Technology Assessment Institutionalisation in Nigeria.” This presentation took place at the official inauguration of the HTA Steering Committee and the formal launch of HTA activities across Nigeria on Wednesday. The Coordinating Minister of Health and Social Welfare, Prof. Muhammad Ali Pate, officially flagged off the event.

According to Dr. Ohiri, embedding HTA into the system will strengthen evidence-based decision-making regarding healthcare coverage, reimbursement policies, pricing strategies, and resource allocation. This is a critical step as Nigeria strives to achieve Universal Health Coverage. His presentation highlighted that “HTA provides the evidence-based methodology to ensure those resources are spent efficiently and equitably.” He clarified that HTA is not being developed as an isolated technical program but rather as an integral component of broader reforms designed to enhance the NHIA’s strategic purchasing capabilities. The presentation further explained, “Strategic purchasing requires deliberate decisions about what healthcare to purchase, for whom, from whom, at what price and on the basis of what evidence.” Dr. Ohiri emphasized the growing importance of such evidence, given the expansion of health insurance coverage and the increasing variety and cost of health technologies.

He elaborated that “HTA provides a systematic and multidisciplinary approach to assessing the clinical, economic and wider value of health technologies.” This methodology, he stated, would improve decisions related to designing benefit packages, determining coverage, processing reimbursements, facilitating adoption of new technologies, setting prices, and allocating resources effectively.

As part of its strategic purchasing reforms, the NHIA commenced efforts to bolster its HTA capacity, leading to the establishment of a Strategic Purchasing Department and a dedicated HTA Division in 2025. Since then, the Authority has developed essential foundational documents, including an HTA Framework, a Reference Case, Process Guidelines, a Deliberative Process, Committee Terms of Reference, a Conflict of Interest Policy, and a Stakeholder Mapping and Analysis. These documents, as noted in the presentation, establish the governance structure and operational guidance necessary to transform HTA from an emerging technical activity into a consistent institutional process.

Furthermore, the NHIA has invested in local expertise, sponsoring two PhD students and two master’s students for postgraduate HTA training at Mahidol University in Bangkok, Thailand. The Authority also conducted and published the Nigerian EQ-5D-5L valuation study, generating locally relevant data crucial for calculating quality-adjusted life years. The presentation underscored the significance of this, stating, “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 rigorously test its framework, the NHIA commissioned and successfully completed three pilot HTA assessments. These assessments focused on kidney replacement therapy, colorectal cancer screening, and the use of sorafenib for advanced liver cancer. Specifically, the kidney replacement therapy assessment evaluated the cost-utility of dialysis versus kidney transplantation, while the colorectal cancer study investigated various screening strategies. The sorafenib assessment involved a swift evaluation of clinical and economic data concerning advanced liver cancer treatment.

A significant milestone was reached in October 2025 when the Coordinating Minister officially approved the National HTA, followed by the endorsement of the HTA Steering Committee. Wednesday’s inauguration and official flag-off signify a pivotal transition from merely developing the NHIA’s internal HTA capabilities and testing its methodologies to establishing a fully coordinated national HTA system.

The newly inaugurated Steering Committee is tasked with providing strategic oversight and guidance, ensuring transparent prioritization of HTA topics, enhancing methodological quality, implementing robust conflict-of-interest safeguards, and fostering engagement among stakeholders and citizens. It will also support capacity development, promote the utilization of Nigerian-specific evidence, and strengthen the mechanisms through which HTA findings can inform health policy, benefit packages, strategic purchasing, and reimbursement decisions.

This development aligns with broader health financing reforms aimed at expanding health insurance coverage, improving financial protection for citizens, and ensuring more efficient utilization of available healthcare resources. The National Health Financing Policy Dialogue, which took place from September 1 to 4, 2025, under the theme “Reimagining the Future of Health Financing in Nigeria,” saw government officials, policymakers, development partners, civil society organizations, academics, and the private sector convene to discuss sustainable and equitable health financing. HTA was prominently featured in these discussions as a vital tool for evidence-informed priority-setting.