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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
M01AB01 INDOCID B Indometacin - 100mg 100mg Suppository 424,910 L.L
M01AB01 INDOMEL G Indometacin - 100mg 100mg Suppository 222,694 L.L
M01AE01 IBUSOL G Ibuprofen - 100mg/5ml 100mg/5ml Suspension 309,724 L.L
B03AC IVIRON G Iron (sucrose) - 100mg/5ml 100mg/5ml Injectable concentrated solution 1,745,203 L.L
L01CE02 IRINOTECAN GP PHARM G Irinotecan HCl trihydrate - 100mg/5ml 100mg/5ml Injectable concentrated solution 5,239,642 L.L
L01CE02 IRINOTECAN HYDROCHLORIDE G Irinotecan HCl - 100mg/5ml 100mg/5ml Injectable concentrate for solution 2,085,644 L.L
L01CE02 IRINOTECAN THYMOORGAN G Irinotecan HCl - 100mg/5ml 100mg/5ml Injectable concentrated solution 6,111,796 L.L
L01CE02 IRNOCAM 100 G Irinotecan HCl - 100mg/5ml 100mg/5ml Injectable solution 7,320,947 L.L
J06BB04 IMMUNOGLOBULINE HUMAINE DE L'HEPATITE B LFB BioHuman Hepatitis B immunoglobulin (human) - 100UI/ml 100UI/ml Injectable solution 6,853,730 L.L
J06BA02 IG VENA BioHuman Human normal immunoglobulin - 10g/200ml 10g/200ml Injectable solution 55,897,163 L.L
C01DA08 ISDN G Isosorbide dinitrate - 10mg 10mg Tablet 311,771 L.L
C01DA08 ISODEX G Isosorbide dinitrate - 10mg 10mg Tablet 138,224 L.L
L01FF03 IMFINZI BioTech Durvalumab - 120mg/2.4ml 120mg/2.4ml Injectable solution 59,776,110 L.L
L01FF03 IMFINZI BioTech Durvalumab - 120mg/2.4ml 120mg/2.4ml Injectable solution 59,776,110 L.L
L01EF01 IBRANCE B Palbociclib - 125mg 125mg Capsule 172,164,216 L.L
L01EF01 IBRANCE B Palbociclib - 125mg 125mg Tablet, film coated 172,164,216 L.L
L01EL01 IMBRUVICA B Ibrutinib - 140mg 140mg Tablet, film coated 194,761,420 L.L
N05AX13 INVEGA SUSTENNA B Paliperidone palmitate - 150mg 150mg Injectable suspension, prolonged release 27,480,995 L.L
C09CA04 IBECARD 150- IPS G Irbesartan - 150mg 150mg Tablet, film coated 564,414 L.L
C09CA04 IRBAVEL 150 G Irbesartan - 150mg 150mg Tablet, film coated 564,414 L.L
C09CA04 IRBESARTAN ARROW G Irbesartan - 150mg 150mg Tablet 470,345 L.L
G01AF05 IFENEC G Econazole nitrate - 150mg 150mg Ovule 546,944 L.L
L01EA05 ICLUSIG B Ponatinib - 15mg 15mg Tablet, film coated 103,555,839 L.L
D10BA01 ISOSUPRA LIDOSE G Isotretinoin - 16mg 16mg Capsule, hard 1,826,282 L.L
R03BB04 INHALEX G Tiotropium bromide - 18mcg 18mcg Capsule, inhalation 1,906,913 L.L
J01DH03 INVANZ B Ertapenem - 1g 1g Injectable concentrated powder for solution 3,785,604 L.L
J06BA02 IG VENA BioHuman Human normal immunoglobulin - 1g/20ml 1g/20ml Injectable solution 7,474,948 L.L
L01EK01 INLYTA B Axitinib - 1mg 1mg Tablet, film coated 57,595,789 L.L
J06BA02 IG VENA BioHuman Human normal immunoglobulin - 2.5g/50ml 2.5g/50ml Injectable solution 17,011,323 L.L
M01AE01 IBUPROFEN B. BRAUN G Ibuprofen - 200mg/50ml 200mg/50ml Injectable solution 161,261 L.L
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