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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
M03AX01 DYSPORT BioTech Clostridium botulinum type A neurotoxin complex - 500units 500units Injectable powder for solution 42,726,155 L.L
M03AX01 DYSPORT BioTech Clostridium botulinum type A neurotoxin complex - 300units 300units Injectable powder for solution 14,625,182 L.L
A15A DYNAMOGEN G Arginine Aspartate - 1g/10ml, Glutodine (Cyproheptadine ?-ketoglutarate) - 3mg/10ml Solution 1,019,976 L.L
R01AD58 DYMISTA B Fluticasone propionate - 50mcg/actuation, Azelastine HCl - 137mcg/actuation Spray, suspension 2,183,744 L.L
G04CA52 DUTASTERIDE/TAMSULOSINE ARROW G Tamsulosin HCl - 0.4mg, Dutasteride - 0.5mg Capsule 1,337,123 L.L
G04CB02 DUTASTERIDE BIOGARAN G Dutasteride - 0.5mg 0.5mg Capsule, soft 1,112,702 L.L
G04CB02 DUTASTERIDE ARROW LAB G Dutasteride - 0.5mg 0.5mg Capsule 1,166,455 L.L
G04CA52 DUTAMSUVITAE G Tamsulosin HCl - 0.4mg, Dutasteride - 0.5mg Capsule, hard 2,168,962 L.L
A03AA04 DUSPATALIN RETARD B Mebeverine HCl - 200mg 200mg Capsule 895,581 L.L
N02AB03 DUROGESIC B Fentanyl - 4.2mg 25mcg/h Patch 1,509,135 L.L
N02AB03 DUROGESIC B Fentanyl - 8.4mg 50mcg/h Patch 3,019,614 L.L
N02AB03 DUROGESIC B Fentanyl - 16.8mg 100mcg/h Patch 5,911,563 L.L
G04BE08 DURALIS 5 G Tadalafil - 5mg 5mg Tablet, film coated 1,791,790 L.L
G04BE08 DURALIS G Tadalafil - 10mg 10mg Tablet, film coated 1,187,701 L.L
G04BE08 DURALIS G Tadalafil - 20mg 20mg Tablet, film coated 624,567 L.L
G04BE08 DURALIS G Tadalafil - 20mg 20mg Tablet, film coated 1,204,979 L.L
D11AH05 DUPIXENT BioTech Dupilumab - 200mg 200mg Injectable solution 123,001,362 L.L
D11AH05 DUPIXENT BioTech Dupilumab - 200mg 200mg Injectable solution 123,001,362 L.L
D11AH05 DUPIXENT BioTech Dupilumab - 300mg 300mg Injectable solution 123,001,362 L.L
D11AH05 DUPIXENT BioTech Dupilumab - 300mg 300mg Injectable solution 123,001,362 L.L
G03DB01 DUPHASTON B Dydrogesterone - 10mg 10mg Tablet, film coated 935,314 L.L
A06AD11 DUPHALAC B Lactulose - 6.7g/10ml 6.7g/10ml Solution 454,219 L.L
S01ED51 DUOTRAV B Timolol (maleate) - 5mg, Travoprost - 40mcg Drops solution 1,933,789 L.L
R03AL02 DUOLIN RESPULES G Salbutamol (sulfate) - 2.5mg/2.5ml, Ipratropium bromide (monohydrate) - 500mcg/2.5ml Inhaltion solution with nebuliser 417,935 L.L
R05D DULSANA WITH CODEINE B Menthol - 0.25mg/5ml, Ammonium chloride - 100mg/5ml, Codeine phosphate - 10mg/5ml, Ephedrine HCl - 4mg/5ml, Carbinoxamine maleate - 2mg/5ml Syrup 273,888 L.L
R05X DULSANA MILD B Menthol - 0.125mg/5ml, Citric acid - 10mg/5ml, Sodium citrate - 20mg/5ml, Ammonium chloride - 50mg/5ml, Ephedrine HCl - 1.8mg/5ml, Carbinoxamine maleate - 1mg/5ml Syrup 216,295 L.L
R05X DULSANA COUGH B Menthol - 0.25mg/5ml, Ammonium chloride - 100mg/5ml, Ephedrine HCl - 4mg/5ml, Carbinoxamine maleate - 2mg/5ml Syrup 223,974 L.L
N06AX21 DULOXETINE BIOGARAN G Duloxetine HCl - 30mg 30mg Capsule, gastro-resistant 573,821 L.L
N06AX21 DULOXETINE BIOGARAN G Duloxetine HCl - 60mg 60mg Capsule, gastro-resistant 573,821 L.L
N06AX21 DULOXA 60 G Duloxetine HCl - 60mg 60mg Capsule, delayed release 831,903 L.L
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