Received: 8 April 2026
Accepted: 24 April 2026
Published online: 29 April 2026
УДК: 614.27(574)
DOI: 10.53511/pharmkaz.2026.2.3
THE STAGES OF DEVELOPMENT OF THE OUTPATIENT PHARMACEUTICAL SUPPLY
SYSTEM IN KAZAKHSTAN (LITERATURE REVIEW)
Zhanzhigitova K.Zh.¹ , Yeraliyeva B.A.², Buribayeva Zh. K. ², Janbatyrova A.Ye. ²
¹ Kazakhstan’s Medical University «KSPH», Almaty, Kazakhstan
²Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan
Introduction. The outpatient pharmaceutical supply system in Kazakhstan is a key component of healthcare and has been the focus of active reforms in recent decades. An analysis of its development stages allows for the assessment of achieved results and the identification of directions for further improvement.
Objective. To present a brief overview of the evolution of the outpatient drug supply system in Kazakhstan and compare its key institutional features with selected international cost recovery models for medicines.
Materials and Methods. This study was conceived as a narrative review with elements of historical, structural and comparative analysis of politics. The review was based on scientific publications, national regulatory documents, official reports, and materials on international health policy published between 1991 and 2025. Literature search was conducted in the databases PubMed, Scopus, Web of Science, Google Scholar and e-Library using keywords related to outpatient drug provision, reimbursement of drug costs, pharmaceutical policy, evaluation of medical technologies and the healthcare system of Kazakhstan. Sources related to outpatient drug provision, cost recovery mechanisms, pharmaceutical policy reforms, or international drug supply models were included. Since the purpose of the study was an analytical synthesis rather than a
systematic synthesis of data, the PRISMA methodology was not applied.
Results. Four key stages in the development of Kazakhstan’s outpatient pharmaceutical supply ODP system were identified: decentralized (1991–2004), transitional (2005–2009), centralized (2010–2017), and insurance-digital (from October 2017 to the present). The reforms introduced mechanisms of centralized procurement, formulary system, electronic prescriptions, and integration with the compulsory health insurance system. A comparative analysis with countries such as Germany, Poland, the USA, Russia, Belarus, Canada, the United Kingdom, and Australia showed that Kazakhstan is moving toward a mixed model with a high degree of state participation and digitalization, but with a limited HTA system and co-payment mechanisms. In addition, an author’s conceptual model was proposed that classifies Kazakhstan’s outpatient drug supply system as a hybrid transitional model combining government-guaranteed financing, centralized procurement, insurance integration, and new evidence-based cost recovery mechanisms.
Discussion. The results demonstrate positive dynamics in the development of Kazakhstan’s ODP model toward improving accessibility and transparency; however, challenges remain related to budget sustainability, regional disparities in coverage, and the need for further implementation of evidence-based and economic tools in decision-making.
Conclusion. Kazakhstan has made substantial progress in modernizing its outpatient pharmaceutical provision system. Ensuring its long-term sustainability requires further advancement in digital integration, broader implementation of health technology assessment (HTA), continuous optimization of reimbursement lists, and strengthened financing mechanisms
within the framework of social health insurance.
Keywords: outpatient pharmaceutical provision, beneficiary (eligible) patients, free medicines, state guarantees, social support, preferential (subsidized) provision, dispensary observation (follow-up care), drug cost reimbursement, mandatory health insurance (MHI)
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