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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
C01DX12 CORVASAL 2MG B Molsidomine - 2mg 2mg Tablet, scored 1,092,992 L.L
C01DX12 CORVASAL 4MG B Molsidomine - 4mg 4mg Tablet 492,742 L.L
C09AA04 COVERSYL ARGININE B Perindopril arginine - 10mg 10mg Tablet, film coated 452,875 L.L
C09AA04 COVERSYL ARGININE B Perindopril arginine - 5mg 5mg Tablet, film coated 452,875 L.L
L01DB01 CAELYX B Doxorubicin HCl pegylated liposomes - 20mg/10ml 20mg/10ml Injectable concentrated solution 34,821,487 L.L
L01DB02 CERUBIDINE B Daunorubicin (HCl) - 20mg 20mg Injectable powder for solution 10,943,137 L.L
S02D CERULYSE B Xylene - 5g/100g 5g/100g Drops solution 339,992 L.L
J06BA02 CLAIRYG BioHuman Human normal immunoglobulin G - 50mg/ml 5g/100ml Injectable solution 42,296,819 L.L
J06BA02 CLAIRYG BioHuman Human normal immunoglobulin G - 50mg/ml 10g/200ml Injectable solution 77,418,284 L.L
J06BA02 CUVITRU BioHuman Human normal immunoglobulin - 4g/20ml 200mg/ml Injectable solution 29,806,627 L.L
J06BA02 CUVITRU BioHuman Human normal immunoglobulin - 8g/40ml 200mg/ml Injectable solution 53,593,818 L.L
J06BA02 CLAIRYG BioHuman Human normal immunoglobulin G - 50mg/ml 5g/100ml Injectable solution L.L
G03GA01 CHORIOMON BioHuman Human Chorionic Gonadotrophin - 5,000IU 5,000IU Injectable lyophilised powder for solution+diluent 6,306,653 L.L
G03GA05 CINNAL-f BioHuman Follitropin alfa - 900IU/1.5ml 900IU/1.5ml Injectable solution 14,826,544 L.L
G03GA05 CINNAL-f BioHuman Follitropin alfa - 450IU/0.75ml 450IU/0.75ml Injectable solution 7,372,177 L.L
L03AB07 CINNOVEX BioTech Interferon beta-1a - 30mcg 30mcg Injectable solution 39,804,728 L.L
H01AC01 CINNATROPIN BioTech Somatropin recombinant - 5mg/1.5ml 5mg/1.5ml Injectable solution 4,699,417 L.L
H01AC01 CINNATROPIN BioTech Somatropin recombinant - 10mg/1.5ml 10mg/1.5ml Injectable solution 9,012,607 L.L
L01FG02 CYRAMZA BioTech Ramucirumab - 500mg/50ml 500mg/50ml Injectable solution L.L
L04AB04 CINNORA BioTech Adalimumab - 40mg/0.8ml 40mg/0.8ml Injectable solution 14,817,734 L.L
L04AC10 COSENTYX BioTech Secukinumab - 150mg/ml 150mg/ml Injectable solution 102,120,767 L.L
L01FG02 CYRAMZA BioTech Ramucirumab - 100mg/10ml 100mg/10ml Injectable solution 47,779,251 L.L
L01FG02 CYRAMZA BioTech Ramucirumab - 500mg/50ml 500mg/50ml Injectable solution 218,656,548 L.L
L01FX28 COLUMVI BioTech Glofitamab - 10mg/10ml 10mg/10ml Injectable concentrate for solution 349,443,660 L.L
L01FX28 COLUMVI BioTech Glofitamab - 2.5mg/2.5ml 2.5mg/2.5ml Injectable concentrate for solution 87,389,307 L.L
L04AC10 COSENTYX BioTech Secukinumab - 150mg/ml 150mg/ml Injectable solution L.L
H05AA02 CINNOPAR BioTech Teriparatide - 250mcg/ml 250mcg/ml Injectable solution 15,275,833 L.L
H05BX01 CINACALCET ARROW BioTech Cinacalcet - 30mg 30mg Tablet, coated 8,768,039 L.L
H05BX01 CINACALCET ARROW BioTech Cinacalcet - 90mg 90mg Tablet, coated, scored 22,062,995 L.L
H05BX01 CINACALCET ARROW BioTech Cinacalcet - 60mg 60mg Tablet, coated, scored 16,494,074 L.L
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