OBJECTIVES: As is the case with many of the Commonwealth of Independent Countries (CIS), since the collapse of the Soviet Union, both Kazakhstan and Uzbekistan have been re-building healthcare provision, and improving access to medications for their population. This study compares the two separate paths the countries have taken, and aims to establish the outcomes achieved by the two systems as well as the direction of future reforms. METHODS: Secondary research focused on analysing the systems in place in the two countries, focusing on drug provision. The study assessed the mechanisms in place, drawing comparisons between the two systems, with a particular focus on the outcomes achieved. RESULTS: Uzbekistan provides medications free of cost for certain categories of patients, while in Kazakhstan, the government has approved a list of drugs that are provided for free as part of the guaranteed volume of free medical care. In both the cases these fall under an outpatient setting. Although the procurement of drugs is carried out mostly via tenders, Kazakhstan’s system involves establishing price ceilings. In Uzbekistan, retail and wholesale margins are controlled. Between 2002-2012, public health expenditure as a percentage of total health expenditure rose from 54% to 58% in Kazakhstan and from 45% to 53% in Uzbekistan. Life expectancy however, increased from 65.9 to 69.6 years in Kazakhstan and from 67.1 to 68.1 years in Uzbekistan. CONCLUSIONS: With growing government health expenditure , reflecting the expansion of the healthcare systems, the countries are likely to increasingly look into containing costs. Given that some pricing mechanism is already in place in Kazakhstan, it may consider implementing tighter pricing regulations, moving closer to those seen in Europe. In Uzbekistan, the government may potentially consider expanding the beneficiary categories while ensuring competiveness within the tendering process.