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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
D07XC03 ELICASAL G Mometasone furoate - 1mg/g, Salicylic acid - 50mg/g Ointment 462,282 L.L
D07AC13 ELOCOM B Mometasone furoate - 1mg/g 0.10% Lotion 282,207 L.L
D10AF02 ERYFLUID B Erythromycin base - 40mg/ml 4% Lotion 542,912 L.L
D10AF02 ERYFLUID B Erythromycin base - 4% 4% Lotion 486,471 L.L
J07BC01 ENGERIX-B 20 B Hepatitis B, purified antigen - 20mcg/ml 20mcg/ml Injectable suspension 1,652,926 L.L
J07BC01 ENGERIX-B 10 B Hepatitis B, surface antigen - 10mcg/0.5ml 10mcg/0.5ml Injectable suspension 1,042,822 L.L
N02CD02 EMGALITY BioTech Galcanezumab - 120mg/ml 120mg/ml Injectable suspension 37,250,732 L.L
M05BX06 EVENITY BioTech Romosozumab - 105mg/1.17ml 105mg/1.17ml Injectable solution 56,729,091 L.L
B02AA02 EXACYL B Tranexamic acid - 500mg/5ml 500mg/5ml Injectable solution 748,520 L.L
V03AF03 EUROFOLIC G Folic acid as Calcium Folinate Hydrate - 50mg/5ml 10mg/ml Injectable solution 5,305,490 L.L
V03AF03 EUROFOLIC G Folic acid as Calcium Folinate Hydrate - 100mg/10ml 10mg/ml Injectable solution 5,872,592 L.L
J01MA02 ESTECINA 200MG G Ciprofloxacine (lactate) - 200mg/100ml 200mg/100ml Injectable solution 32,190,251 L.L
J01MA12 EVOXIL HELLAS G Levofloxacin - 500mg/100ml 500mg/100ml Injectable solution 959,504 L.L
B05DA EXTRANEAL (ICODEXTRIN 7.5%) TWIN BAG B Sodium lactate - 4.5g/l, Magnesium Chloride - 0.051g/l, Calcium chloride - 0.257g/l, Sodium chloride - 5.4g/l, Icodextrin - 75.0 g/l Injectable solution 1,998,025 L.L
B05DA EXTRANEAL (ICODEXTRIN 7.5%) SINGLE BAG B Sodium lactate - 4.5g/l, Magnesium Chloride - 0.051g/l, Calcium chloride - 0.257g/l, Sodium chloride - 5.4g/l, Icodextrin - 75.0 g/l Injectable solution 1,998,025 L.L
L04AB01 ETANERREL BioTech Etanercept - 25mg/0.5ml 25mg/0.5ml Injectable solution L.L
B03XA01 EPOMAX BioTech Erythropoietin recombinant human (Epoetin alfa) - 2000UI/ml 2000UI/ml Injectable solution 7,849,606 L.L
B03XA01 EPOMAX BioTech Erythropoietin recombinant human (Epoetin alfa) - 4000UI/ml 4000UI/ml Injectable solution 1,243,054 L.L
B03XA01 EPOTEX 4000 BENTA BioTech Erythropoietin recombinant human (Epoetin alfa) - 4,000IU 4,000IU Injectable solution 1,209,458 L.L
B03XA01 EPOTEX 4000 BENTA BioTech Erythropoietin recombinant human (Epoetin alfa) - 4,000IU 4,000IU Injectable solution 5,488,046 L.L
L01FE01 ERBITUX BioTech Cetuximab - 100mg/20ml 100mg/20ml Injectable solution L.L
B03XA01 EPOMAX BioTech Erythropoietin recombinant human (Epoetin alfa) - 10000UI/ml 10000UI/ml Injectable solution 2,486,109 L.L
B03XA01 EPOTIN BioTech Erythropoietin recombinant human (Epoetin alfa) - 2,000IU 2,000IU Injectable solution 9,206,440 L.L
B03XA01 EPOTIN BioTech Erythropoietin recombinant human (Epoetin alfa) - 4,000IU/ml 4,000IU/ml Injectable solution 11,317,795 L.L
L04AA33 ENTYVIO BioTech Vedolizumab - 108mg 108mg Injectable solution 92,478,560 L.L
L04AA33 ENTYVIO BioTech Vedolizumab - 108mg 108mg Injectable solution 92,478,560 L.L
L01BA01 EBETREXAT G Methotrexate - 50mg/5ml 50mg/5ml Injectable solution 1,507,821 L.L
L04AB01 ENBREL BioTech Etanercept - 50mg 50mg Injectable solution 52,197,598 L.L
L04AB01 ENBREL BioTech Etanercept - 50mg 50mg Injectable solution 52,197,598 L.L
L04AB01 ERELZI BioTech Etanercept - 50mg 50mg Injectable solution 59,029,176 L.L
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