Nigeria Launches New Health Spending System to Assess Medicines, Treatments and Medical Technologies
Nigeria Launches New Health Spending System to Assess Medicines, Treatments and Medical Technologies
By Iroyin Yoruba Television News Desk
Nigeria has formally begun institutionalising Health Technology Assessment, a system the National Health Insurance Authority says will help determine how scarce healthcare resources are allocated and whether medicines, medical devices, treatments and other health interventions provide sufficient value before they are adopted or financed.
The National Health Insurance Authority, NHIA, launched the new process on Wednesday, September 16, 2026, with the inauguration of a Health Technology Assessment Steering Committee.
The Director-General and Chief Executive Officer of the NHIA, Dr Kelechi Ohiri, announced the development during a presentation titled “Progress of Health Technology Assessment Institutionalisation in Nigeria.”
Health Technology Assessment, commonly abbreviated as HTA, is a multidisciplinary approach used to examine the clinical, economic, social and ethical implications of health technologies and interventions.
In practical terms, the new approach is intended to provide decision-makers with evidence before scarce health funds are committed to a particular medicine, medical device, diagnostic technology, treatment or service.
The NHIA's move comes as Nigeria continues efforts to expand health-insurance coverage while dealing with competing demands on limited healthcare resources.
Rather than making decisions only on whether a treatment or technology exists, HTA introduces a structured process for examining evidence about whether an intervention works, what it costs, what health benefits it provides and how its adoption could affect the wider health system.
The World Health Organization describes HTA as a systematic and multidisciplinary evaluation that considers the direct and indirect consequences of health technologies and provides evidence to support health-policy decisions.
For Nigeria, the institutionalisation of the system represents a move toward making evidence and value assessment a more formal part of healthcare financing and purchasing decisions.
What Health Technology Assessment Actually Does
Health Technology Assessment is sometimes confused with medical research, regulatory approval or clinical practice.
It is related to all three but serves a different purpose.
A medicine may already have evidence showing that it can treat a particular disease.
A medical device may already have regulatory approval.
A diagnostic test may already be commercially available.
A hospital procedure may already be used by doctors.
HTA asks a broader question: given the resources available, what does the intervention deliver in terms of health outcomes, cost and wider consequences?
That can involve examining clinical effectiveness, safety, economic costs, social consequences, ethical considerations and the impact on the health system.
The WHO describes HTA as a bridge between research and policy because it brings evidence together in a form that can support decisions by governments, insurers and other healthcare institutions.
This distinction is important for Nigeria because healthcare budgets are not unlimited.
A health system may face several competing demands at the same time.
It may need medicines for infectious diseases, treatment for cancer and other non-communicable diseases, maternal healthcare, vaccines, diagnostics, medical equipment and emergency services.
HTA is designed to help decision-makers compare those demands using evidence rather than considering each intervention in isolation.
Why the NHIA Is Introducing the System Now
The NHIA's decision is linked to the expansion and reform of health insurance in Nigeria.
The National Health Insurance Authority was established under the National Health Insurance Authority Act of 2022, which replaced the previous 1999 legislation.
The new law broadened the institutional framework for health insurance and universal health coverage.
As the insurance system expands, the amount of healthcare that insurance purchasers and public programmes may be expected to finance can also increase.
That creates a need for systematic decisions about which interventions should receive priority.
The NHIA has previously described HTA as an important component of evidence-based purchasing.
The agency's Strategic Purchase Department includes officials with expertise in health economics and HTA, and the authority's own institutional information identifies the NHIA Health Technology Assessment Initiative among the policy and intervention areas developed within the organisation.
The latest announcement therefore represents the formalisation of work that has been developing within the authority rather than the discovery of the concept for the first time.
A Steering Committee Has Been Inaugurated
The latest development includes the inauguration of a Health Technology Assessment Steering Committee.
The committee is expected to support the institutional framework required to make HTA functional within Nigeria's healthcare system.
The NHIA's announcement did not mean that every medical intervention in Nigeria would immediately be subjected to a completely new approval process.
Rather, it marks the beginning of a more structured institutional approach.
For such a system to work, technical expertise is required in several fields.
Health economists may assess costs and economic value.
Clinicians can evaluate medical evidence.
Epidemiologists can examine disease patterns and health outcomes.
Pharmacists can contribute information about medicines.
Researchers can assess clinical studies.
Health-policy specialists can examine system-level implications.
Ethicists and patient representatives can contribute perspectives on fairness and access.
The multidisciplinary nature of HTA is therefore central to the process.
The Cost of Healthcare Is Only One Part of the Question
HTA does not simply ask whether a medicine is cheap or expensive.
An inexpensive intervention that produces little benefit may not necessarily represent good value.
Likewise, an expensive treatment that substantially improves outcomes for patients with a serious condition could have a different economic and clinical profile.
The assessment therefore considers the relationship between resources used and outcomes achieved.
The WHO's guidance explains that HTA can evaluate the clinical, economic, ethical and social implications of medical technologies and support decisions about adoption or reimbursement.
This is particularly relevant when healthcare systems are deciding whether to include new medicines or technologies in publicly financed benefit packages.
Medicines Can Be Evaluated Before Wider Financing
Medicines are among the areas where HTA can have a direct effect.
A new medicine may enter the market with evidence of effectiveness.
However, health authorities may still need to determine whether it should be financed through a public insurance programme.
Questions can include:
How effective is the medicine compared with existing treatment?
How much does it cost?
Does it reduce hospital admissions?
Does it extend life?
Does it improve quality of life?
Are there cheaper alternatives with similar outcomes?
How many patients are likely to need it?
What would widespread adoption cost the health system?
Those questions can be examined through an HTA process.
The objective is not necessarily to reject expensive medicines.
It is to give decision-makers evidence with which to understand the consequences of adopting them.
Medical Devices Are Also Covered
The same principle applies to medical devices.
Hospitals and healthcare systems constantly encounter new equipment and technologies.
Some may improve diagnosis.
Others may improve treatment.
Some may reduce the time required for a procedure.
Others may provide alternatives to existing equipment.
But acquiring a device can involve more than its purchase price.
There may be maintenance costs.
Healthcare workers may require training.
Replacement parts may have to be imported.
The equipment may require specialised infrastructure or electricity.
Consumables may create recurring expenses.
A device may therefore have a much larger financial impact over its useful life than its initial price suggests.
HTA can help decision-makers examine those wider costs.
The WHO's medical-device HTA guidance specifically notes the importance of evaluating economic and clinical implications when healthcare systems consider new technologies.
Diagnostic Technologies Can Also Be Assessed
Diagnostic tests are another area where evidence-based assessment can be relevant.
A diagnostic technology can affect the entire treatment pathway.
If a test detects a disease earlier, it could potentially allow treatment to begin sooner.
But the value of a diagnostic test depends on several factors.
The test must be sufficiently accurate.
Healthcare facilities need the capacity to administer it.
Health workers need to interpret the results correctly.
Patients who test positive need access to appropriate treatment.
If those links are missing, simply introducing a new diagnostic technology may not produce the expected health gains.
HTA allows those system-level considerations to be examined rather than evaluating the technology in isolation.
Treatment Procedures Can Be Compared
HTA can also be used to assess procedures and models of care.
For example, a healthcare system may have several possible approaches for managing a particular condition.
One may involve hospital admission.
Another may rely more heavily on outpatient care.
Another may involve a new technology that reduces the length of treatment.
The assessment can consider both clinical outcomes and the resources required by each approach.
This can help health authorities understand whether changing the way a service is delivered could improve outcomes or reduce avoidable expenditure.
Nigeria Has Been Discussing HTA for Years
Although the NHIA's formal institutionalisation announcement is new, research into HTA and priority-setting in Nigeria is not.
A peer-reviewed study published in 2020 examined the capacity, needs and perspectives of Nigerian stakeholders regarding HTA.
The researchers interviewed 31 participants drawn from decision-making, policy, academia, civil society, development and professional organisations.
The study found that stakeholders considered HTA an important tool for priority-setting, particularly in areas such as health-benefit packages, clinical guidelines and service improvement.
The research also identified weaknesses that could make HTA difficult to implement.
These included limited human capacity and inadequate availability and accessibility of suitable local data.
The findings suggested that Nigeria needed greater capacity in research methods, HTA and data management.
Those earlier findings remain relevant to the current institutionalisation effort because a formal HTA system depends on precisely those capabilities.
The Data Problem
One of the most important requirements for HTA is reliable data.
An assessment cannot be stronger than the evidence available to the people conducting it.
Health authorities need information about disease burden, treatment outcomes, costs, healthcare utilisation and patient populations.
Nigeria's large and diverse population makes this particularly important.
Disease patterns can differ by region.
Access to health services varies.
The cost of delivering services can differ between locations.
The availability of healthcare professionals and facilities is not uniform.
A national decision therefore needs to account for conditions across different parts of the country.
The 2020 Nigerian HTA research found that participants had concerns about the availability and accessibility of suitable local data.
The challenge for the new institutional framework will therefore include developing and maintaining the evidence base needed to support assessments.
Local Evidence Matters
Health-economic evidence generated in another country may provide useful information, but it cannot automatically be transferred to Nigeria without adjustment.
Healthcare prices differ.
Disease prevalence differs.
Patient behaviour differs.
Healthcare delivery systems differ.
Insurance structures differ.
Exchange rates affect the cost of imported medicines and equipment.
Staffing costs can also differ.
For those reasons, Nigeria's HTA system will need local evidence wherever possible.
This does not mean international research becomes irrelevant.
Clinical trials and international studies can provide important evidence about whether a treatment works.
But economic and system-level assessments may need to incorporate Nigerian costs, disease patterns and delivery conditions.
The Role of the First Nigerian EQ-5D-5L Value Set
Nigeria has also recently strengthened its capacity to conduct economic evaluations through development of a locally derived EQ-5D-5L value set.
The EQ-5D-5L is a standardised health-related quality-of-life instrument used in health economics.
A national value set helps researchers translate responses about health status into values that can be incorporated into economic evaluations.
A 2026 report from an NHIA-linked researcher described the publication of Nigeria's first EQ-5D-5L value set as a milestone for locally grounded health-economic evaluation and HTA.
This type of development matters because HTA frequently requires an assessment of not only how long people live but also the quality of the health they experience.
Reliable local health-utility values can therefore strengthen the evidence available for economic modelling.
What Universal Health Coverage Has to Do With It
Universal health coverage means people should be able to obtain needed health services without suffering financial hardship.
For Nigeria, expanding insurance coverage is one component of that objective.
But expanding coverage raises another question.
What services should the system finance?
A health insurance programme cannot necessarily pay for every available medical intervention for every person without limit.
There are finite resources.
The benefit package must therefore reflect available financing and healthcare priorities.
HTA can contribute to this process by providing evidence on the value and consequences of different interventions.
The earlier Nigerian study concluded that HTA could support more efficient allocation of resources as the country works toward universal health coverage.
Why Evidence-Based Purchasing Matters
Health insurance authorities do more than collect funds.
They also purchase healthcare services on behalf of enrolled populations.
Strategic purchasing involves deciding what services to purchase, from whom, under what conditions and at what price.
HTA can provide evidence for some of those decisions.
For example, if two interventions offer broadly similar outcomes but have significantly different costs, the evidence can help inform purchasing decisions.
If a new intervention produces better outcomes but requires substantially more funding, an assessment can help policymakers understand the additional resources involved.
The decision itself remains a policy choice.
HTA does not automatically determine what government must purchase.
Instead, it provides structured evidence to support that decision.
The Difference Between Evidence and Policy
This distinction is particularly important.
An HTA report can conclude that a technology is clinically effective.
It can also find that the technology is expensive relative to an existing alternative.
Those findings do not by themselves establish a government policy.
Policymakers may also consider equity, political commitments, disease severity, vulnerable populations, ethical considerations and available funding.
The purpose of HTA is to make those choices more transparent and evidence-informed.
The WHO describes HTA as a process that supports decision-making rather than replacing policymakers.
What Could Change for Patients
The ultimate purpose of healthcare-financing reform is its effect on patients.
If HTA is implemented effectively, patients could potentially benefit from a system that places greater emphasis on treatments supported by evidence.
It could also help reduce spending on interventions that provide little or uncertain benefit.
However, the effect will not necessarily be immediate.
The system first needs institutional rules, trained personnel, reliable evidence, assessment procedures and mechanisms for applying the findings.
Patients may therefore see the results indirectly through changes in insurance benefit packages, purchasing decisions and the availability of particular technologies.
Avoiding Waste Does Not Mean Cutting Care
The NHIA's announcement has been framed partly around reducing waste.
That should not be interpreted simply as cutting healthcare spending.
A health system can reduce waste while maintaining or increasing access to effective care.
For example, avoiding an ineffective intervention could free resources for another service that produces better outcomes.
Similarly, better procurement decisions could allow a health programme to purchase more of a useful intervention with the same budget.
The central concept is therefore value.
The WHO's HTA guidance says the process can help ensure that health resources are spent efficiently and effectively while supporting equitable access.
The Importance of Transparency
A formal HTA system also creates a need for transparent procedures.
If a medicine or device is excluded from a benefit package, stakeholders may want to know why.
If a particular technology receives public financing, decision-makers should be able to explain the evidence supporting it.
Transparent assessment criteria can help build confidence among healthcare professionals, patients, manufacturers and insurers.
The WHO has emphasised governance, transparency and accountability as important elements in institutionalising HTA.
For Nigeria, the credibility of the new system will therefore depend not only on technical calculations but also on how openly decisions and evidence are handled.
Pharmaceutical Companies Will Also Be Affected
The institutionalisation of HTA could have implications for pharmaceutical manufacturers and suppliers.
Companies seeking inclusion of medicines in publicly financed health programmes may increasingly need to provide evidence about clinical effectiveness, safety and economic value.
That can change the nature of discussions between suppliers and public purchasers.
Instead of focusing only on whether a product has regulatory approval, negotiations may increasingly involve questions about comparative effectiveness and affordability.
This does not mean pharmaceutical companies will no longer market medicines through other channels.
It means that evidence requirements can become more important when public financing is involved.
Medical Technology Manufacturers Face Similar Questions
Medical-device companies could face comparable requirements.
A supplier proposing a new diagnostic machine, surgical technology or other device may need to demonstrate not only that the technology functions but also what additional benefits it provides and what it will cost to operate.
For Nigeria, this could encourage suppliers to provide stronger evidence and more complete information about lifecycle costs.
It may also encourage consideration of maintenance, training and infrastructure requirements rather than focusing exclusively on purchase prices.
Health Workers Remain Central
HTA does not eliminate the role of doctors, nurses, pharmacists and other health professionals.
Their clinical experience is essential to interpreting evidence.
A technology that appears attractive in an economic model may encounter practical barriers in a real hospital.
Clinicians can identify those issues.
They can also assess whether a proposed intervention is realistic within existing care pathways.
The multidisciplinary nature of HTA is designed to bring those perspectives together.
Patients and the Public Also Have a Role
The social and ethical dimensions of HTA mean that patient and public perspectives can be relevant.
Two treatments may produce similar clinical results but have different effects on patients' daily lives.
An intervention may also be highly effective for a small population with a severe disease.
Questions about fairness and access can therefore become important.
A technically efficient decision may not answer every ethical question.
The institutional process will need to determine how such considerations are incorporated.
The Challenge of Implementation
The biggest test for Nigeria will not be the launch ceremony.
It will be implementation.
The country already has research showing that HTA requires greater technical capacity and better access to data.
Institutionalising the process therefore means building a permanent system capable of producing assessments and ensuring that decision-makers actually use them.
That involves training.
It involves data systems.
It involves research partnerships.
It involves methodological standards.
It involves governance.
And it involves a mechanism for translating assessment findings into purchasing and coverage decisions.
Building Nigerian Expertise
Nigeria will require specialists who can conduct economic evaluations, systematic reviews, evidence synthesis and other forms of HTA research.
The NHIA already has personnel with health-economics and HTA expertise, including officials who have worked on the agency's HTA initiative.
However, institutionalisation requires capacity beyond a small group of specialists.
Universities, research institutes, professional organisations and government agencies can all contribute to developing the skills required.
Training programmes will also be necessary to maintain capacity as staff change.
The Role of Universities and Research Institutions
Academic institutions can contribute clinical and economic research that feeds into HTA.
Nigeria has universities with medical schools, public-health programmes, pharmacy departments and health-economics expertise.
Connecting these institutions to government decision-making could strengthen the evidence base.
The 2020 stakeholder study specifically identified research capacity and training as important components of developing HTA in Nigeria.
A sustained relationship between policymakers and researchers can help ensure that studies address questions that are relevant to actual healthcare decisions.
What the Steering Committee Will Need to Establish
The newly inaugurated steering committee has a significant institutional task.
Among the practical questions for any national HTA framework are:
What technologies should be assessed?
Who can request an assessment?
What evidence must manufacturers provide?
Who conducts the technical evaluation?
How are conflicts of interest managed?
How are patients and healthcare professionals consulted?
How are economic evaluations conducted?
How are recommendations communicated?
How are decisions reviewed when new evidence becomes available?
What happens when evidence is uncertain?
These are system-design questions rather than issues that can be solved simply by creating a committee.
The effectiveness of the new framework will depend on how these processes are established.
HTA Does Not Mean Every New Technology Will Be Rejected
Another important point is that HTA is not designed to block innovation.
New technologies can offer substantial improvements in healthcare.
A new medicine may treat a condition for which previous options were ineffective.
A new diagnostic device may detect disease earlier.
A new surgical technology may reduce complications.
HTA can help identify such benefits while also examining their costs and system implications.
A technology that demonstrates strong clinical and economic value may have a stronger evidence base for adoption.
What Happens When Evidence Is Uncertain?
Healthcare decisions are not always made with perfect information.
New technologies may have limited long-term evidence when they first become available.
A rare disease may make large clinical trials difficult.
A treatment may be effective but have uncertain long-term costs.
HTA frameworks therefore need methods for dealing with uncertainty.
Decision-makers may require additional evidence after an intervention is introduced.
They may also review coverage decisions as new information becomes available.
This creates a continuing cycle rather than a one-time assessment.
The Potential Impact on Health Insurance Benefits
One of the most direct areas where HTA could have an impact is the design of health insurance benefit packages.
A benefit package determines which services and interventions are covered for beneficiaries.
As Nigeria expands health insurance, demand for additional treatments and technologies may increase.
The NHIA has previously highlighted the pressure created by high-cost interventions, including areas such as dialysis, oncology and long-term management of non-communicable diseases.
HTA can provide a framework for assessing such interventions in relation to available resources.
Again, the assessment does not make the final policy decision by itself.
It supplies evidence for that decision.
The Financial Protection Question
Nigeria has historically faced substantial reliance on out-of-pocket healthcare payments.
That means many households pay directly when they need medical services.
The long-term goal of health-insurance expansion is to reduce the financial burden associated with healthcare.
But insurance itself must be financially sustainable.
If benefit commitments expand faster than available financing, the system can come under pressure.
HTA can help identify which interventions provide sufficient value to justify public financing.
This links HTA directly to the sustainability of health insurance.
What Could Happen Next
Following the launch of the steering committee, the next stage will involve developing the institutional mechanisms through which HTA assessments are conducted and used.
The NHIA will need to translate the broad principle into operational procedures.
That could involve identifying priority areas for assessment, building technical teams, establishing assessment standards and strengthening data systems.
The authority will also need to coordinate with other parts of Nigeria's health system.
The Federal Ministry of Health and Social Welfare, state governments, healthcare providers, professional organisations, research institutions and development partners all have roles in the wider health system.
A Longer-Term Change in Healthcare Decision-Making
The significance of the latest announcement is therefore broader than a new committee.
It represents an attempt to change how some healthcare spending decisions are made.
Instead of asking only whether a treatment is available or whether a technology has been approved, decision-makers can increasingly ask what evidence shows about its effectiveness, cost and wider impact.
That approach can make healthcare financing more systematic.
It can also make difficult decisions easier to explain because policymakers can point to a defined assessment process.
The Need for Public Understanding
As HTA becomes more established, explaining the system to the public will be important.
Healthcare decisions can directly affect patients.
If a medicine is not included in an insurance package, patients may want to understand the reason.
If a new technology is adopted, they may want to know what evidence supports it.
If coverage changes, healthcare professionals will need clear guidance.
Communication will therefore be part of implementation.
Technical HTA reports may be necessary for specialists, but public-facing explanations will also be required.
Nigeria's Health Financing System Is Entering Another Phase
The NHIA's launch of formal HTA institutionalisation adds another component to Nigeria's ongoing health-financing reforms.
The country is trying to expand insurance coverage, improve purchasing, strengthen primary healthcare and reduce financial barriers to medical treatment.
Those objectives require decisions about how available resources are used.
HTA is intended to make at least some of those decisions more evidence-driven.
The system will not solve all of Nigeria's healthcare-financing challenges.
It will not by itself increase the health budget.
It will not automatically eliminate out-of-pocket payments.
It will not build hospitals or train doctors.
But it can provide a structured way of evaluating how the resources already available are allocated among competing healthcare needs.
Conclusion
Nigeria's National Health Insurance Authority has launched the institutionalisation of Health Technology Assessment, inaugurating a steering committee and formally beginning a process intended to strengthen evidence-based healthcare spending.
NHIA Director-General Dr Kelechi Ohiri disclosed the development on Wednesday, September 16, 2026, during the official flag-off of HTA institutionalisation in Nigeria.
The system is designed to evaluate health technologies and interventions using evidence covering areas such as clinical effectiveness, economic implications, social consequences and ethical considerations.
The approach can be applied to medicines, medical devices, diagnostic technologies, treatment procedures and models of healthcare delivery.
For Nigeria's health-insurance system, one important application is expected to be the assessment of interventions considered for public financing.
The move follows years of research and policy discussion about how Nigeria can establish stronger priority-setting mechanisms.
A 2020 study involving Nigerian health-sector stakeholders identified HTA as a useful tool for designing benefit packages, improving clinical guidelines and supporting more efficient resource allocation, while also identifying weaknesses in local data and technical capacity.
The current institutionalisation effort therefore begins with an existing body of research and expertise rather than starting from zero.
The NHIA already has personnel with health-economics and HTA experience, and the authority has previously identified HTA among its strategic initiatives.
The next challenge is implementation.
Nigeria will need reliable data, trained specialists, transparent procedures, appropriate assessment methods and mechanisms for ensuring that evidence actually informs purchasing and coverage decisions.
The process will also need to account for Nigeria's particular healthcare environment, including differences in disease burden, treatment costs, infrastructure and access across regions.
For patients, the eventual effect of the reform may appear through changes in what health-insurance programmes purchase or cover and through decisions about which medical technologies receive public financing.
For healthcare providers, manufacturers and insurers, it could mean greater emphasis on evidence concerning effectiveness, cost and health outcomes.
And for government, it creates a formal mechanism for examining competing healthcare demands before scarce resources are committed.
The launch on September 16 is therefore the beginning of an institutional process, not the completion of the reform.
Its significance will ultimately depend on how effectively Nigeria converts the new HTA framework into transparent, technically sound decisions that improve the value and reach of healthcare spending.