Abstract
High levels of personal spending on medicines can increase household financial vulnerability and reduce access to medical care, especially in the context of regional and social inequalities in health care. The purpose of this study is to assess the relationship between willingness to pay for an insurance policy for medicines in Kazakhstan and socio-economic, medical and linguistic factors, as well as to determine the nature of differences between Kazakh-speaking and Russian-speaking respondents. The empirical basis of the study was made up of data from an online survey conducted in various regions of Kazakhstan. The final analytical sample included 2,695 respondents with their own source of income, including 2,044 Kazakh-speaking and 651 Russian-speaking respondents. The research uses methods of descriptive statistics, comparative analysis, t-tests, permutation tests and OLS regression. The results showed that the average willingness to pay for drug insurance among Kazakh—speaking respondents was about $65.4, while among Russian-speaking respondents it was about $46.4; the differences are statistically significant at the 5% level (t-test = 2.26; p < 0.024). Regression analysis showed that willingness to pay is related to current expenses for medicines, self-assessment of health status, region of residence, type of settlement and language of communication in the household. The results of the study emphasize the importance of a differentiated approach to the development of mechanisms for drug insurance and communication policy in order to increase the availability of medical care, reduce financial barriers to treatment and ensure the sustainable development of the healthcare economy in Kazakhstan.