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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
J05AF10 ENTECAVIR ARROW G Entecavir - 1mg 1mg Tablet, coated 18,701,506 L.L
J05AF10 ENTECAVIR BIOGARAN G Entecavir - 1mg 1mg Tablet, coated 19,080,319 L.L
J05AF10 ENTRILIV G Entecavir - 1mg 1mg Tablet, film coated 19,165,898 L.L
J05AF10 HEPCAVIR 1 G Entecavir monohydrate - 1mg 1mg Tablet, film coated 18,998,515 L.L
J05AF10 APO-ENTECAVIR G Entecavir - 0.5mg 0.5mg Tablet 28,943,287 L.L
J05AF10 AVIRAVIR G Entecavir monohydrate - 0.5mg 0.5mg Tablet, film coated 32,224,230 L.L
J05AF10 ENTECAVIR ARROW G Entecavir - 0.5mg 0.5mg Tablet, coated 18,701,506 L.L
J05AF10 ENTECAVIR BIOGARAN G Entecavir - 0.5mg 0.5mg Tablet, coated 19,080,319 L.L
J05AF10 ENTRILIV G Entecavir - 0.5mg 0.5mg Tablet, film coated 19,165,898 L.L
J05AF10 HEPCAVIR 0.5 G Entecavir monohydrate - 0.5mg 0.5mg Tablet, film coated 18,998,515 L.L
J05AF13 VEMLIDY B Tenofovir alafenamide fumarate - 25mg 25mg Tablet, film coated 26,997,299 L.L
J05AG01 NEPINE G Nevirapine - 200mg 200mg Tablet 5,921,678 L.L
J05AG03 STOVIRENZ G Efavirenz - 600mg 600mg Tablet, film coated 6,857,456 L.L
J05AG06 PIFELTRO B Doravirine - 100mg 100mg Tablet, film coated 27,819,434 L.L
J05AH02 TAMIFLU B Oseltamivir (phosphate) - 75mg 75mg Capsule 1,464,788 L.L
J05AH02 TAMIFLU B Oseltamivir (phosphate) - 75mg 75mg Capsule 1,464,788 L.L
J05AH02 FLUMIVIR G Oseltamivir - 75mg 75mg Capsule 1,384,158 L.L
J05AH02 VIRIFLU G Oseltamivir - 75mg 75mg Capsule 1,371,615 L.L
J05AP08 NUCLEOBUVIR G Sofosbuvir - 400mg 400mg Tablet, film coated 50,670,440 L.L
J05AP55 EPCLUSA B Sofosbuvir - 400mg, Velpatasvir - 100mg Tablet, film coated 991,921,769 L.L
J05AP56 VOSEVI B Sofosbuvir - 400mg, Velpatasvir - 100mg, Voxilaprevir - 100mg Tablet, film coated 891,634,849 L.L
J05AR01 CONDINE G Lamivudine - 150mg, Zidovudine - 300mg Tablet, film coated 5,818,474 L.L
J05AR01 LAMIVUDINE/ ZIDOVUDINE ARROW G Lamivudine - 150mg, Zidovudine - 300mg Tablet, coated, scored 15,643,319 L.L
J05AR03 TRUVADA B Emtricitabine - 200mg, Tenofovir disoproxil - 245mg Tablet, film coated 21,319,383 L.L
J05AR03 EMZAVIR G Emtricitabine - 200mg, Tenofovir disoproxil fumarate - 300mg Tablet, film coated 18,701,506 L.L
J05AR06 VITRICOMB G Emtricitabine - 200mg, Tenofovir disoproxil fumarate - 300mg, Efavirenz - 600mg Tablet, film coated 22,191,783 L.L
J05AR10 KALUVIA G Lopinavir - 200mg, Ritonavir - 50mg Tablet, film coated 7,632,790 L.L
J05AR12 TELADINE G Lamivudine - 300mg, Tenofovir disoproxil fumarate - 300mg Tablet 17,454,739 L.L
J05AR13 TRIUMEQ B Dolutegravir - 50mg, Abacavir sulfate - 600mg, Lamivudine - 300mg Tablet, film coated 74,756,237 L.L
J05AR18 GENVOYA B Emtricitabine - 200mg, Tenofovir alafenamide - 10mg, Elvitegravir - 150mg, Cobicistat - 150mg Tablet, film coated 77,789,650 L.L
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