FG Adopts New System To Cut Waste In Healthcare Spending
The Federal Government of Nigeria has officially adopted Health Technology Assessment (HTA) as a national framework to guide healthcare coverage and spending.
The initiative was formally flagged off in Abuja during the inauguration of the HTA Steering Committee. The move represents a structural pivot toward evidence-based healthcare financing as the country seeks to accelerate progress toward Universal Health Coverage (UHC) while protecting citizens from catastrophic medical expenses.
A Systematic Shift Toward "Strategic Purchasing"
Under the leadership of the National Health Insurance Authority (NHIA) and the Federal Ministry of Health and Social Welfare, HTA introduces a multidisciplinary approach to evaluate the clinical effectiveness, economic value, safety, and equity impact of medical interventions before they are funded or integrated into national benefit packages.
Speaking at the launch, the Coordinating Minister of Health and Social Welfare, Prof. Muhammad Ali Pate, emphasized that the reform is not merely a cost-cutting measure, but a mechanism to maximize the health returns on every naira spent.
"It is not just about reducing healthcare expenditure or restricting access to important life-saving tools," Prof. Pate clarified. "Rather, the objective is to ensure that scarce resources are directed towards interventions that deliver meaningful health benefits and value for money, while ensuring that poorer and marginalized Nigerians are not excluded."
For decades, healthcare funding decisions in Nigeria were hindered by fragmented procurement, reliance on external international guidelines, and high out-of-pocket costs which WHO figures show account for over 70% of national health expenditures. HTA introduces a data-driven model known as "strategic purchasing," shifting the system from reactive funding to deliberate choice-making.
Key Pillars of the HTA Framework
According to the Director-General of the NHIA, Dr. Kelechi Ohiri, the institutionalization of HTA will directly govern decisions regarding reimbursement, pricing, benefit-package design, and overall health resource allocation.
Dr. Ohiri noted that strategic purchasing requires answers to five fundamental questions:
What healthcare services and interventions to purchase;
For whom the interventions should be provided;
From whom services should be procured;
At what price they should be paid for; and
On the basis of what evidence decisions should be made.
To support this institutional shift, the NHIA established a dedicated HTA Division and completed foundational pilot studies.
These early pilot assessments evaluated:
Kidney Replacement Therapy: Analyzing the cost-utility of chronic dialysis versus kidney transplantation to inform long-term reimbursement models.
Colorectal Cancer Screening: Comparing alternative population-wide screening strategies to determine optimal economic and health outcomes.
Advanced Liver Cancer Treatments: Conducting rapid clinical and economic evaluations for high-cost targeted therapies such as Sorafenib.
In addition, the authority completed the Nigerian EQ-5D-5L Valuation Study, generating localized data to evaluate quality-adjusted life years (QALYs). This local evidence reduces reliance on foreign health-economic models, tailoring policy decisions directly to Nigerian demographics and clinical realities.
Stakeholder Roles and Governance Architecture
The newly inaugurated HTA Steering Committee will serve as the oversight body, tasked with maintaining methodological rigor, managing potential conflicts of interest, and ensuring transparent priority-setting.
Governance Mechanism
HTA Steering Committee; Strategic oversight, prioritizing assessment topics, ensuring methodology safeguards.
NHIA Strategic Purchasing Dept; Integrating HTA findings into health insurance benefit packages and provider rates.
Deliberative Process Guidelines; Ensuring multi-stakeholder participation, including civil society and clinical experts.
Local Value Sets (EQ-5D-5L);Using population-specific preferences to evaluate health-related quality of life.
Broader Context of Health Financing Reforms
The adoption of HTA comes amid expanding public investments in Nigeria's health ecosystem.
With public allocations to primary health care and disbursements via the Basic Health Care Provision Fund (BHCPF) scaling up nationwide, pressure has mounted on policymakers to prove that spending delivers measurable health outcomes.
By tying health insurance coverage directly to HTA recommendations, the Federal Government aims to establish a transparent, sustainable model that reins in inflation on diagnostic tests, pharmaceuticals, and specialized care.
Officials emphasize that the ultimate success of HTA will be judged not by the volume of studies produced, but by its practical ability to shift standard government purchasing behaviors, safeguard public funds, and lower financial barriers for everyday Nigerian families.
