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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
B01AX05 ARIXTRA B Fondaparinux sodium - 7.5mg/0.6ml 7.5mg/0.6ml Injectable solution 12,004,668 L.L
J01CR02 AUGMENTIN ES B Amoxicillin (trihydrate) - 600mg/5ml, Clavulanic Acid (potassium) - 42.9mg/5ml 642.9mg/5ml Powder for suspension 846,621 L.L
J01CR02 AMOCLAN BID G Amoxicillin (trihydrate) - 600mg/5ml, Clavulanic Acid (potassium) - 42.9mg/5ml 642.9mg/5ml Powder for suspension 507,972 L.L
J01CR02 AUGMENTIN B Amoxicillin (trihydrate) - 500mg, Clavulanic Acid (potassium) - 125mg 625mg Tablet 639,958 L.L
J01CR02 AMOCLAN FORTE G Amoxicillin (trihydrate) - 500mg, Clavulanic Acid (potassium) - 125mg 625mg Tablet 170,668 L.L
M01AH05 ARCOXIA B Etoricoxib - 60mg 60mg Tablet, film coated 1,685,178 L.L
M01AH05 ARTRIX 60 G Etoricoxib - 60mg 60mg Tablet, film coated 1,054,596 L.L
N06BA09 APO-ATOMOXETINE G Atomoxetine (HCl) - 60mg 60mg Capsule 4,731,669 L.L
C08DB01 APO-DILTIAZ G Diltiazem HCl - 60mg 60mg Tablet 545,600 L.L
R05CB01 ACC LONG G N-acetylcysteine - 600mg, Vitamin C - 75mg 600mg Tablet, effervescent 286,238 L.L
P02CA03 ANDAZOL G Albendazole - 200mg 6 Tablet, film coated 302,365 L.L
L01CD01 ABRAXANE BioTech Paclitaxel Albumin- bound - 5mg/ml 5mg/ml Injectable powder for dispersion 17,850,751 L.L
M05BA08 ACLASTA B Zoledronic acid (monohydrate) - 5mg/100ml 5mg/100ml Injectable solution 21,075,062 L.L
B01AF02 APIXEL G Apixaban - 5mg 5mg Tablet, film coated 1,750,579 L.L
G04BD08 ASOLFENA G Solifenacin succinate - 5mg 5mg Tablet, film coated 971,598 L.L
B01AF02 APO-APIXABAN G Apixaban - 5mg 5mg Tablet 3,084,119 L.L
B01AF02 AVIXAN G Apixaban - 5mg 5mg Tablet, film coated 2,777,275 L.L
G04BE08 APO-TADALAFIL G Tadalafil - 5mg 5mg Tablet 1,635,456 L.L
G04BE08 AMOS G Tadalafil - 5mg 5mg Film, orodispersible 2,743,998 L.L
L01EG02 AFINITOR B Everolimus - 5mg 5mg Tablet 149,280,650 L.L
R06AX27 AERIUS B Desloratadine - 5mg 5mg Tablet, film coated 430,030 L.L
R06AX27 AERIUS B Desloratadine - 5mg 5mg Tablet, film coated 430,030 L.L
R06AX27 AERIALLERG G Desloratadine - 5mg 5mg Tablet, film coated 400,465 L.L
B03BB01 ACFOL G Folic acid - 5mg 5mg Tablet 355,798 L.L
C07AB07 APO-BISOPROLOL G Bisoprolol fumarate - 5mg 5mg Tablet 923,220 L.L
N05AH03 APO-OLANZAPINE ODT G Olanzapine - 5mg 5mg Tablet, orally disintegrating 1,463,444 L.L
C08CA01 AMLOR B Amlodipine besylate - 5mg 5mg Capsule 560,382 L.L
C08CA01 AMLOR B Amlodipine besylate - 5mg 5mg Capsule 560,382 L.L
C08CA01 AMLINE G Amlodipine - 5mg 5mg Tablet, scored 358,358 L.L
N06DA02 ARICEPT B Donepezil HCl - 5mg 5mg Tablet, film coated 3,254,787 L.L
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