Building a Sound Foundation for Kenya’s Health Benefits Package: Lessons from NICE and Opportunities for Stakeholder Leadership

By Dr. Ahmed Kamau, Health Economist

In April 2025, Kenya took a pivotal step toward Universal Health Coverage (UHC) with the gazettement of the Health Benefits Package and Tariffs Advisory Panel. As we embark on this journey, there’s an opportunity to borrow from global best practices, like those of the National Institute for Health and Care Excellence (NICE) in the UK, while acknowledging our unique economic, institutional, and health system realities.

Critical Pillars for a Strong Foundation

A strong foundation for effective health technology assessment (HTA) begins with transparent and inclusive governance. Decision-making processes must be clear, participatory, and publicly accountable. For example, the UK’s NICE has established standing committees with diverse representation. Similarly, Kenya should ensure that panels include voices from counties, professional societies, and patient groups to build credibility and trust.

Equally important is the need for a clear scope and well-defined prioritisation criteria. Policymakers must specify which services, technologies, and populations fall under review, and decisions should be guided by structured criteria such as disease burden, cost-effectiveness, equity, and feasibility. This clarity not only streamlines the process but also ensures fairness in how limited resources are allocated.

A third pillar is the establishment of a robust evidence infrastructure. Investment in local data systems is crucial to generate the evidence needed for clinical and economic value assessments. While this infrastructure is being developed, Kenya can adapt regional and global evidence to its local context, using pragmatic HTA methods to bridge data gaps.

The fourth pillar is the adoption of a structured HTA process. Standardised methods for reviewing clinical effectiveness, cost-effectiveness, and budget impact are essential to ensure consistency and credibility in decision-making. Given current capacity, Kenya can begin with a simplified HTA framework, gradually building sophistication as expertise and resources grow.

Finally, success will depend on sustainable financing and phased implementation. Benefit packages should be aligned with the country’s fiscal space, avoiding commitments that strain budgets. A phased roll-out, supported by continuous monitoring and recalibration, will enable Kenya to adapt and refine its HTA approach while ensuring long-term sustainability.

Roles for Stakeholders

Stakeholders play distinct but complementary roles in strengthening Health Technology Assessment (HTA) processes. Professional societies provide clinical guidance, define care pathways, and recommend relevant outcome measures, while also helping to identify appropriate comparators and flagging variations in practice. 

Patient groups bring the lived experience, ensuring that outcomes reflect what truly matters to patients, while also highlighting issues of treatment acceptability and equity.

The pharmaceutical industry, beyond its commercial interests, contributes by submitting robust evidence, co-creating managed access agreements, and supporting capacity-building efforts in HTA.

Meanwhile, academia plays a vital role in generating and synthesizing evidence, training HTA analysts, and advancing local research in health economics and policy. Jointly, these stakeholders form the backbone of a transparent, inclusive, and evidence-driven HTA ecosystem

What Kenya Can Learn and Easily Apply

1. Start with Cost-Comparison and Budget Impact Analyses: Rather than jumping into complex cost-utility models, Kenya should begin with simpler economic evaluations that inform budgetary decisions.

   
   

2. Institutionalise Stakeholder Involvement: From day one, Kenya should make it routine to include patients, clinicians, and implementers in evaluation discussions.

   
   

3. Adapt and Localize Existing Frameworks: NICE’s HTA manual offers a ready template. Kenya can tailor this to suit its scale and data limitations.

   
   

4. Embed Evaluation and Iteration: Build feedback loops. Periodically review what's in the benefits package based on affordability, utilization, and health outcomes.

Closing Reflection

Kenya’s economy may be small, but that’s not a limitation, it’s an opportunity. With fewer layers of bureaucracy, we have the chance to design a leaner, more agile benefits system that is community-led, evidence-informed, and equity-driven. We can draw inspiration from global leaders like NICE, while confidently charting our own path