Received: 16.05.2026
Accepted: 06.08.2026
Published online: 21.08.2026
UDC: 615.12:614.2:004.67
DOI: 10.53511/pharmkaz.2026.4.4
REPEATED WITHDRAWAL OF MEDICINES AS AN INDICATOR OF SYSTEMIC RISKS
OF DIGITAL TRACEABILITY IN THE HEALTHCARE SYSTEM OF THE REPUBLIC OF KAZAKHSTAN
Dinara A. Akolbekova¹, Sholpan L. Akhelova¹, Zhalgaskali M. Arystanov¹
¹Astana Medical University, Astana, Kazakhstan
Introduction. In the context of the digital transformation of the healthcare system of the Republic of Kazakhstan, ensuring transparency in the circulation of medicines has become one of the key tools for improving the efficiency of outpatient pharmaceutical provision. In this regard, the analysis of anomalous operations within the digital labeling and traceability system of medicines is of particular importance, as it enables the identification of organizational, informational, and economic risks.
The aim of the study was to analyze cases of repeated withdrawal of medicines from circulation within the digital traceability system of the Republic of Kazakhstan and to assess their significance as indicators of systemic risks in healthcare.
Materials and methods. A retrospective analytical study of medicine circulation operations within the digital labeling system under the guaranteed volume of free medical care and compulsory social health insurance was conducted. The study included data from retail pharmaceutical entities across all regions of the Republic of Kazakhstan collected from July 1, 2025, to April 30, 2026. Structural, comparative, statistical, and risk-oriented analytical methods were applied.
Results. The analysis showed that the potential economic damage amounted to 20.74 million tenge, while the total value of repeatedly registered withdrawal operations amounted to 31.74 million tenge. The highest frequency of anomalies was identified in Turkestan Region, Almaty city, Zhambyl Region, and Almaty Region. The highest financial risk was recorded in Almaty city, Astana city, and Turkestan Region. It was shown that the majority of anomalous operations were associated with high-turnover medicines used in the treatment of chronic non-communicable diseases. The main contributing factors included duplication of operations in information systems, data synchronization failures, and the absence of automated format-logical control.
Discussion. The findings suggest that repeated withdrawal of medicines is primarily associated with limitations of the digital traceability system, including duplication of operations, data synchronization failures, and insufficient automated format-logical control. These anomalies may therefore be considered indicators of systemic risks requiring further improvement of digital monitoring and control mechanisms.
Conclusions. Repeated withdrawal of medicines from circulation may be considered a significant digital indicator of systemic risks in healthcare. The findings justify the implementation of risk-oriented monitoring, strengthening inter-system integration, and automation of control procedures within the pharmaceutical supply chain.
Keywords: digital labeling, medicines, traceability, outpatient pharmaceutical provision, pharmaceutical audit, risk-oriented control, Republic of Kazakhstan
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