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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
L01FF04 BAVENCIO BioTech Avelumab - 200mg/10ml 200mg/10ml Injectable concentrate for solution 104,075,577 L.L
L01FG01 BEVACIREL BioTech Bevacizumab - 400mg/16ml 400mg/16ml Injectable solution 49,744,595 L.L
L01FG01 BIVASTINA 400 BioTech Bevacizumab - 400mg/16ml 400mg/16ml Injectable concentrate for solution 92,353,609 L.L
L01FG01 BIVASTINA 400 BioTech Bevacizumab - 400mg/16ml 400mg/16ml Injectable concentrate for solution 53,111,763 L.L
L01FG01 BEVACIREL BioTech Bevacizumab - 100mg/4ml 100mg/4ml Injectable solution 14,719,570 L.L
L01FG01 BIVASTINA 100 BioTech Bevacizumab - 100mg/4ml 100mg/4ml Injectable concentrate for solution 22,840,337 L.L
L01FG01 BIVASTINA 100 BioTech Bevacizumab - 100mg/4ml 100mg/4ml Injectable concentrate for solution 12,021,318 L.L
H05AA02 BONTEO BioTech Teriparatide - 20mcg/dose 20mcg/dose 17,383,843 L.L
M03AX01 BOTOX BioTech Clostridium botulinum type A neurotoxin complex - 100U 100U Injectable powder for solution 18,625,995 L.L
M03AX01 BOTOX BioTech Clostridium botulinum type A neurotoxin complex - 100U 100U Injectable powder for solution 18,625,995 L.L
L01FX07 BLINCYTO BioTech Blinatumomab - 35mcg 35mcg Injectable lyophilised powder for solution+stabilizer 239,484,334 L.L
G03DA04 BIOGEST BioTech Progesterone, bio-identical - 200mg 200mg Pessary 1,804,780 L.L
G03DA04 BIOGEST BioTech Progesterone, bio-identical - 100mg/2ml 100mg/2ml Injectable solution 2,328,879 L.L
G03DA04 BIOGEST BioTech Progesterone, bio-identical - 400mg 400mg Pessary 1,083,137 L.L
L01XG01 BORTEZOMIB PHARMINICIO G Bortezomib - 3.5mg 3.5mg Injectable powder for solution 13,007,658 L.L
C01EB17 BRADIREM G Ivabradine (HCl) - 5mg 5mg Tablet, film coated 1,134,203 L.L
L01XG01 BORTEZOMIB SHILPA G Bortezomib - 3.5mg 3.5mg Injectable lyophilised powder 9,902,420 L.L
C01EB17 BRAVIGO G Ivabradine (HCl) - 5mg 5mg Tablet, film coated 1,237,679 L.L
L01XG01 BORTEZOMIB SPC G Bortezomib - 3.5mg 3.5mg Injectable powder for solution 15,743,401 L.L
C01EB17 BRADIREM G Ivabradine (HCl) - 7.5mg 7.5mg Tablet, film coated 1,134,203 L.L
C01EB17 BRAVIGO G Ivabradine (HCl) - 7.5mg 7.5mg Tablet, film coated 1,237,679 L.L
D07AC01 BETASONE G Betamethasone (valerate) - 1mg/g 1mg/g Cream 120,306 L.L
L01AA09 BENDAVIVAL G Bendamustine HCl - 100mg 100mg Injectable concentrated powder for solution L.L
N07BC01 BUPENSAN G Buprenorphine - 8mg 8mg Tablet 1,259,180 L.L
N07BC01 BUPRENORPHINE ARROW G Buprenorphine - 8mg 8mg Tablet 1,115,389 L.L
N07BC01 BUPRENORPHINE ARROW G Buprenorphine - 2mg 2mg Tablet 563,070 L.L
L01DC01 BLEO-CELL G Bleomycin (sulfate) - 15mg 15mg Injectable powder for solution 3,817,857 L.L
S01GX08 BRUNISTILL G Ketotifen - 250mcg/ml 250mcg/ml Drops solution 940,690 L.L
C02KX01 BOSENTAN ARROW G Bosentan (monohydrate) - 125mg 125mg Tablet, film coated 51,483,159 L.L
M05BA06 BONAFOR G Ibandronic acid (monosodium monohydrate) - 150mg 150mg Tablet, film coated 383,955 L.L
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