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Syrian Refugees Crisis Impact on Lebanese Public Hospitals- Financial Impact Analysis: APIS Report


The impact of the Syrian crisis on Lebanon has been profound particularly in the healthcare sector. The influx of Syrian refugees has strained the public hospitals and their ability to respond to the crisis, resulting in:
  • An increased demand for healthcare services;
  • An increase in unpaid health services to refugees;
  • A sharp rise in communicable diseases and emergence of new diseases in Lebanon;
  • Increased risks of epidemics such as water-borne diseases, measles, and tuberculosis 1.
Neither United Nations High Commissioner of Refugees (UNHCR) nor other Non-Governmental Organizations (NGO) was able to meet the required level of funding to provide refugees with an acceptable level of secondary and tertiary healthcare services. They, therefore, decided to change their model of response in terms of healthcare support to Syrian refugees. As of 2014, UNHCR started covering 75% instead 85% of the hospitalization cost, leaving the patient with the remaining share of 25% to be paid out of pocket or by a third party. The healthcare referrals covered by UNHCR are limited to deliveries and life-threatening emergencies 2.

Hospitals are overburdened with Syrian patients who are unable to pay their part of the bill (increased to 25% of their total hospital fees) as well as patients whose hospitalizations are not subsidized at all. Some hospitals have put in place strategies to recover as much of the 25% as possible (deposits, retaining IDs/corpses, inflating bills). Referral of uncovered Syrian patients with complicated morbidities to public hospitals has become a common practice by private hospitals.

Overwhelmed by the high demand of healthcare by Syrian refugees, public hospitals end up treating patients without any specific reimbursement scheme thus creating a huge financial burden. This burden adds up to the existing difficult financial situation of public hospitals, putting the whole healthcare sector under stress. Public hospitals are restrained from completing their mission and incapable of providing healthcare services neither to Syrians refugees nor to Lebanese citizens...
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ATC Name B/G Ingredients Dosage Form Price
L01EL01 IMBRUVICA B Ibrutinib - 420mg 420mg Tablet, film coated 562,026,556 L.L
L01EL02 CALQUENCE B Acalabrutinib - 100mg 100mg Capsule 650,653,454 L.L
L01EM03 PIQRAY B Alpelisib - 150mg 150mg Tablet, film coated 359,195,954 L.L
L01EM03 PIQRAY B Alpelisib - 200mg, Alpelisib - 50mg 150mg Tablet, film coated 359,195,954 L.L
L01EM03 PIQRAY B Alpelisib - 200mg 200mg Tablet, film coated 359,195,954 L.L
L01EX01 SUTENT B Sunitinib maleate - 12.5mg 12.5mg Capsule 54,006,801 L.L
L01EX01 SOVIDEX G Sunitinib maleate - 12.5mg 12.5mg Capsule 36,042,560 L.L
L01EX01 SUNITINIB AQVIDA G Sunitinib maleate - 12.5mg 12.5mg Capsule, hard 38,073,237 L.L
L01EX01 SUTENT B Sunitinib maleate - 25mg 25mg Capsule 98,852,769 L.L
L01EX01 SOVIDEX G Sunitinib maleate - 25mg 25mg Capsule 64,804,314 L.L
L01EX01 SUTENT B Sunitinib maleate - 50mg 50mg Capsule 197,706,574 L.L
L01EX01 SOVIDEX G Sunitinib maleate - 50mg 50mg Capsule 118,623,323 L.L
L01EX01 SUNITINIB AQVIDA G Sunitinib maleate - 50mg 50mg Capsule, hard 125,308,072 L.L
L01EX02 NEXAVAR B Sorafenib - 200mg 200mg Tablet, film coated 82,858,698 L.L
L01EX03 VOTRIENT B Pazopanib HCl - 400mg 400mg Tablet, film coated 77,725,025 L.L
L01EX03 VOTRIENT B Pazopanib HCl - 200mg 200mg Tablet, film coated 42,465,160 L.L
L01EX05 STIVARGA B Regorafenib - 40mg 40mg Tablet, film coated 262,387,816 L.L
L01EX07 CABOMETYX B Cabozantinib - 20mg 20mg Tablet, film coated 424,098,997 L.L
L01EX07 CABOMETYX B Cabozantinib - 40mg 40mg Tablet, film coated 424,098,997 L.L
L01EX07 CABOMETYX B Cabozantinib - 60mg 60mg Tablet, film coated 424,098,997 L.L
L01EX08 LENVIMA B Lenvatinib - 4mg 4mg Capsule, hard 124,450,304 L.L
L01EX08 LENVIMA B Lenvatinib - 10mg 10mg Capsule, hard 124,450,304 L.L
L01EX09 OFEV B Nintedanib - 100mg 100mg Capsule, soft 100,972,184 L.L
L01EX09 OFEV B Nintedanib - 150mg 150mg Capsule, soft 201,946,695 L.L
L01EX10 RYDAPT B Midostaurin - 25mg 25mg Capsule, soft 1,163,291,105 L.L
L01EX10 RYDAPT B Midostaurin - 25mg 25mg Capsule, soft 581,645,553 L.L
L01FA01 MABIXEN 100 BioTech Rituximab - 100mg/10ml 100mg/10ml Injectable concentrate for solution 22,183,393 L.L
L01FA01 MABIXEN 100 BioTech Rituximab - 100mg/10ml 100mg/10ml Injectable concentrate for solution 11,091,696 L.L
L01FA01 MABTHERA BioTech Rituximab - 100mg/10ml 100mg/10ml Injectable concentrated solution 35,722,424 L.L
L01FA01 RITUXIREL BioTech Rituximab - 100mg 100mg/10ml Injectable concentrated solution 11,708,063 L.L
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