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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
J01DH02 AROPEM G Meropenem - 0.5g 0.5g Injectable powder for solution 19,022,727 L.L
J01DH02 ARCHIFAR G Meropenem - 1g 1g Injectable powder for solution 6,443,725 L.L
J01DH02 AROPEM G Meropenem (trihydrate) - 1g 1g Injectable powder for solution 995,723 L.L
J01DH02 AROPEM G Meropenem - 1g 1g Injectable powder for solution 995,723 L.L
J01DH02 AROPEM G Meropenem - 1g 1g Injectable powder for solution 995,723 L.L
J01DH02 AROPEM G Meropenem - 1g 1g Injectable powder for solution 19,022,727 L.L
B02BD08 ARYOSEVEN RT BioTech Eptacog alfa - 1mg 1mg Injectable powder for solution+diluent 16,902,713 L.L
J01DD04 AXONE 1G IM G Ceftriaxone (sodium) - 1g 1g Injectable powder for solution+diluent 438,093 L.L
B02BD08 ARYOSEVEN RT BioTech Eptacog alfa - 1mg 1mg Injectable powder for solution+diluent L.L
J01DD04 AXONE 500MG IM G Ceftriaxone (sodium) - 500mg 500mg Injectable powder for solution+diluent 393,746 L.L
L01BC07 AZACITIDINE EVER PHARMA G Azacitidine - 100mg/100ml 25mg/ml Injectable powder for suspension 10,967,854 L.L
N05AX12 ABILIFY MAINTENA B Aripiprazole - 400mg 400mg Injectable powder for suspension, prolonged release+solvent 29,491,998 L.L
B05AA01 ALBUREL HUMAN ALBUMIN BP BioHuman Albumin human - 20% 20% Injectable solution L.L
L04AB04 ADALIREL BioTech Adalimumab - 40mg 40mg Injectable solution L.L
B01AX05 ARIXTRA B Fondaparinux sodium - 2.5mg/0.5ml 2.5mg/0.5ml Injectable solution 5,341,774 L.L
B01AX05 ARIXTRA B Fondaparinux sodium - 7.5mg/0.6ml 7.5mg/0.6ml Injectable solution 12,004,668 L.L
N02BG06 ACUPAN B Nefopam HCl - 20mg 20mg Injectable solution 365,525 L.L
B05CX01 ALDEX G Dextrose, H2O - 5g/100ml 5g/100ml Injectable solution 174,062 L.L
B05CX01 ALDEX G Dextrose, H2O - 5g/100ml 5g/100ml Injectable solution 174,062 L.L
B05CX01 ALDEX G Dextrose, H2O - 5g/100ml 5g/100ml Injectable solution 170,630 L.L
B05CX01 ALDEX G Dextrose, H2O - 5g/100ml 5g/100ml Injectable solution 182,720 L.L
B05CX01 ALDEX G Dextrose, H2O - 5g/100ml 5g/100ml Injectable solution 205,933 L.L
J06BA02 ARAGAM BioHuman Human normal immunoglobulin - 5g/100ml 5g/100ml Injectable solution 40,075,575 L.L
N02CD01 AIMOVIG BioTech Erenumab - 70mg/ml 70mg/ml Injectable solution 35,423,371 L.L
M05BA08 ACLASTA B Zoledronic acid (monohydrate) - 5mg/100ml 5mg/100ml Injectable solution 21,075,062 L.L
J01GB06 AMICINE G Amikacin (sulfate) - 500mg/2ml 500mg/2ml Injectable solution 1,749,683 L.L
J01GB06 AMIKACIN SULPHATE G Amikacin (sulfate) - 500mg/2ml 500mg/2ml Injectable solution 372,244 L.L
M01AB05 ALMIRAL G Diclofenac sodium - 75mg/3ml 75mg/3ml Injectable solution 415,247 L.L
L04AC07 ACTEMRA BioTech Tocilizumab - 162mg/0.9ml 162mg/0.9ml Injectable solution L.L
C05BB02 AETHOXYSKLEROL B Polidocanol (Lauromacrogol 400) - 0.5% 0.5% Injectable solution 1,441,943 L.L
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