Abstract
Background: Outpatient drug provision is a critical component of primary healthcare systems and a key determinant of treatment continuity, adherence, and equity, yet the effectiveness of publicly funded outpatient drug programs often depends on how policies are implemented at the point of care. This study examined physician awareness, practical experience, and perceived barriers related to outpatient drug provision and drug cost compensation mechanisms in urban primary care settings in Kazakhstan. Methods: A descriptive cross-sectional survey was conducted between September and December 2024 among 380 physicians working in all 33 state-owned urban polyclinics in Almaty, using a structured author-developed questionnaire. Descriptive statistics and Pearson’s chi-square tests were applied to assess associations between physician characteristics and awareness levels. Results: Only 44.0% of physicians confirmed the existence of outpatient drug cost compensation mechanisms in their polyclinics, while 26.0% believed that no such mechanisms existed and 30.0% were unable to provide a definitive answer, indicating that 56.0% lacked accurate awareness. Limited medicine availability and recurrent shortages were frequently reported, with half of physicians advising patients to purchase medicines out of pocket. Physician awareness was significantly associated with professional experience and specialty (p < 0.001). Conclusions: These findings indicate a substantial physician-level implementation gap in outpatient drug provision, suggesting that organizational and informational barriers—rather than insufficient public financing—are the primary drivers, highlighting the need for strengthened governance.