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In the heart of Central Asia, Kazakhstan is making significant changes to its healthcare system, particularly for those living with diabetes. As of mid-July 2025, diabetes treatment has been transferred to the OMSMS package, a move that officials promise will expand access to therapy. However, the changes have left some patients apprehensive about their future access to vital medications.
Diabetes, a disease affecting over half a million people in Kazakhstan, is no longer considered a socially significant disease. The free provision of medications will now depend on participation in the OMS, a mandatory social medical insurance system. For Naïl Zakiiev, a person with type 1 diabetes, this shift is particularly concerning. He currently receives free insulin and test strips, but the cost of pump supplies and sensors amounts to 100-300 thousand tenge each month.
The process of obtaining medications remains largely unchanged. Patients must be registered with a clinic, be under the care of a general practitioner or a specialist, and obtain a free prescription from their doctor. They can present this prescription, along with their ID, at the clinic's pharmacy. Alternatively, patients can use the eGov mobile app to receive a QR code for their prescription and present it at the pharmacy.
However, the funding source and distribution principle have changed. The annual state expenses for the outpatient treatment of patients with diabetes are growing, with 55.5 billion tenge planned for 2025. The purchase list for 2025 includes 50 drug and device names, including insulin like Humalog, test strips such as AT Care No50, and devices like the MiniMed Infusion System.
Yet, there is no clarity on which diabetes medications will no longer be provided free of charge starting in 2025. Some medications, like Mounjaro (Tirzepatid), are generally reimbursed by statutory health insurance for diabetes treatment but not for obesity treatment, reflecting existing distinctions rather than upcoming changes in 2025.
The additional complexity lies in the fact that participation in OCMSS is directly linked to the monthly calculated indicator (MCI), which is indexed annually. This means the cost of medical insurance will only increase, potentially leaving some patients to shoulder the costs for insulin and supplies entirely.
For some patients, this shift means that tomorrow they may be left without vital medications. Over six thousand of these patients are children, and access to insulin and related supplies is a matter of life and death for them. It is crucial that these changes are navigated carefully to ensure continued access to necessary medications for all those affected by diabetes in Kazakhstan.
