Kazakhstan is an upper-middle-income country with per capita GDP of nearly US$13 thousand in 2013. Kazakh’s public healthcare system – UNHS (Unified National Health System) – aims to deliver healthcare coverage to the whole population. The political desire of authorities to provide broader access to healthcare for its populations, along with the growing prevalence of non-communicable diseases (NCDs) such as cardiovascular disease, cancer and diabetes, are placing a strain not only on government budget but also on the healthcare infrastructure in Kazakhstan. Increasing life expectancy is giving rise to the greater burden associated with ageing populations, while governments struggle to balance growing costs with a need to expand healthcare provision to all. At the heart of any cost-containment strategy is a set of tools, ranging from complex risk-sharing schemes and health technology assessment (HTA) through to more simplistic mechanisms, such as prescribing controls and mandatory price cuts. Analysis of cost-management trends in Kazakhstan, relative with international experience, suggests a leaning towards less complex approaches. One reason for this is that before being able to even contemplate more sophisticated initiatives, governments must first address basic infrastructure needs. These include having sufficient doctors and clinics to diagnose and treat patients. There is growing appreciation that cost containment can only be effective when implemented in a systematic manner. Kazakhstan already have informal guidelines in place and are now considered «mature» markets in terms of HTA adoption. Despite the obvious challenges, some would argue that the time for HTA has arrived in Kazakhstan. Implemented correctly, it can play a role in the future of the region, not only as a key component of cost containment but also as a pivotal enabler for the efficient use of resources, as governments look to provide broader access to affordable healthcare for all.