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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
J01FA09 KLACID B Clarithromycin - 500mg 500mg Injectable powder for solution 1,428,505 L.L
J01FA09 KLACID B Clarithromycin - 125mg/5ml 125mg/5ml Granules for suspension 575,165 L.L
J01FA09 KLACID B Clarithromycin - 250mg/5ml 250mg/5ml Granules for suspension 1,698,617 L.L
J01FA09 KLACID RM B Clarithromycin - 500mg 500mg Tablet, modified release 1,173,175 L.L
B02BA01 KONAKION MM PEDIATRIC B Phytomenadione - 2mg/0.2ml 2mg/0.2ml Solution 442,124 L.L
V06DD KETOSTERIL B Calcium - 0.05g, Total nitrogen - 36mg, L-Tyrosine - 30mg, L-Histidine - 38mg, L-Tryptophan - 23mg, L-Threonine - 53mg, L-Lysine Monoacetate - 105mg, Alpha Hydroxyanalogue-DL-Methionine, Calcium Salt - 59mg, Alpha Ketoanalogue-Valine,Calcium Salt - 86mg, Alpha Ketoanalogue-Phenylalanine,Calcium Salt - 68mg, Alpha-Ketoanalogue- Leucine,Calcium Salt - 101mg, Alpha-Ketoanalogue-DL-isoleucine,Calcium Salt - 67mg Tablet, film coated 3,950,897 L.L
N03AX14 KEPPRA B Levetiracetam - 250mg 250mg Tablet, film coated 3,240,855 L.L
N03AX14 KEPPRA B Levetiracetam - 500mg 500mg Tablet, film coated 6,478,288 L.L
J01DB01 KEFLEX B Cefalexin (monohydrate) - 250mg/5ml 250mg/5ml Granules for suspension 477,384 L.L
J01DB01 KEFLEX B Cefalexin (monohydrate) - 500mg 500mg Capsule 659,123 L.L
N03AX14 KEPPRA B Levetiracetam - 1000mg 1,000mg Tablet, film coated 12,202,941 L.L
L01EF02 KISQALI B Ribociclib - 200mg 200mg Tablet, film coated 200,752,977 L.L
M01AE17 KETESSE B Dexketoprofen (trometamol) - 25mg 25mg Tablet, film coated 399,121 L.L
M01AE17 KETESSE B Dexketoprofen (trometamol) - 50mg/2ml 50mg/2ml Injectable concentrated solution 435,405 L.L
M01AE17 KETESSE B Dexketoprofen (trometamol) - 50mg/2ml 50mg/2ml Injectable solution 435,405 L.L
C07AB05 KERLONE B Betaxolol HCl - 20mg 20mg Tablet, film coated, scored 575,165 L.L
J01MA17 KINODROX B Prulifloxacin - 600mg 600mg Tablet, film coated 1,407,835 L.L
L01XG02 KYPROLIS B Carfilzomib - 60mg 60mg Injectable powder for solution L.L
L01EF02 KISQALI B Ribociclib - 200mg 200mg Tablet, film coated L.L
A04AA02 KYTRIL B Granisetron (HCl) - 1mg 1mg Tablet, film coated 2,765,628 L.L
A04AA02 KYTRIL B Granisetron (HCl) - 3mg/3ml 3mg/3ml Injectable solution 3,711,693 L.L
L01XG02 KYPROLIS B Carfilzomib - 60mg 60mg Injectable powder for solution 96,642,005 L.L
J01FA09 KLACID B Clarithromycin - 500mg 500mg Tablet, film coated 1,329,060 L.L
J06BA02 KIOVIG BioHuman Human normal immunoglobulin G - 5g/50ml 5g/50ml Injectable solution 35,639,835 L.L
J06BA02 KIOVIG BioHuman Human normal immunoglobulin G - 10g/100ml 10g/100ml Injectable solution 56,495,332 L.L
J06BA02 KIOVIG BioHuman Human normal immunoglobulin G - 5g/50ml 5g/50ml Injectable solution L.L
L01FD03 KADCYLA BioTech Trastuzumab emtansine - 100mg 100mg Injectable powder for concentrate for solution L.L
L01FD03 KADCYLA BioTech Trastuzumab emtansine - 160mg 160mg Injectable powder for concentrate for solution L.L
L01FF02 KEYTRUDA BioTech Pembrolizumab - 100mg/4ml 100mg/4ml Injectable solution L.L
L04AA52 KESIMPTA BioTech Ofatumumab - 20mg/0.4ml 20mg/0.4ml Injectable solution 96,542,598 L.L
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