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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
M03BX02 SIRDALUD B Tizanidine HCl - 2mg 2mg Tablet 659,104 L.L
M03AC11 SISACURE G Cisatracurium (besylate) - 20mg/10ml 20mg/10ml Injectable solution 1,408,347 L.L
M01AE11 SURGAM B Tiaprofenic acid - 300mg 300mg Tablet 849,308 L.L
M01AE03 SOLKET INFLAMMATION AND PAIN G Ketoprofen Lysine salt - 0.16% 0.16% Spray 946,065 L.L
M01AE03 SOLKET G Ketoprofen Lysine salt - 80mg 80mg Powder for solution 636,981 L.L
M01AE01 SPIDIFEN B Ibuprofen alginate - 400mg 400mg Tablet, film coated 330,585 L.L
M01AC02 SORAL G Tenoxicam - 20mg/2ml 20mg/2ml Injectable lyophilised powder for solution+solvent 588,603 L.L
L04AX04 SOTIRA G Lenalidomide - 25mg 25mg Capsule 76,719,234 L.L
L04AX04 SOTIRA G Lenalidomide - 15mg 15mg Capsule 76,208,289 L.L
L04AX04 SOTIRA G Lenalidomide - 10mg 10mg Capsule 72,248,183 L.L
L04AX04 SOTIRA G Lenalidomide - 5mg 5mg Capsule 68,908,116 L.L
L04AD01 SANDIMMUN NEORAL B Ciclosporin - 100mg/ml 100mg/ml Solution 8,264,592 L.L
L04AD01 SANDIMMUN NEORAL SOFT GELATIN B Ciclosporin - 100mg 100mg Capsule, soft gelatin 8,264,592 L.L
L04AD01 SANDIMMUN NEORAL SOFT GELATIN B Ciclosporin - 25mg 25mg Capsule, soft gelatin 2,385,320 L.L
L04AD01 SANDIMMUN NEORAL SOFT GELATIN B Ciclosporin - 50mg 50mg Capsule, soft gelatin 4,309,703 L.L
L04AD01 SANDIMMUN B Ciclosporin - 50mg/ml 250mg/5ml Injectable concentrated solution 6,992,013 L.L
L04AC18 SKYRIZI BioTech Risankizumab - 150mg 150mg Injectable solution 194,911,251 L.L
L04AC18 SKYRIZI BioTech Risankizumab - 75mg 75mg Injectable solution 194,911,251 L.L
L04AC05 STELARA BioTech Ustekinumab - 130mg 130mg Injectable concentrate for solution 235,593,517 L.L
L04AC05 STELARA BioTech Ustekinumab - 90mg 90mg Injectable solution 157,788,141 L.L
L04AC05 STELARA BioTech Ustekinumab - 90mg 90mg Injectable solution 157,788,141 L.L
L04AC05 STELARA BioTech Ustekinumab - 45mg 45mg Injectable solution 157,788,141 L.L
L04AC05 STELARA BioTech Ustekinumab - 45mg 45mg Injectable solution 157,788,141 L.L
L04AC02 SIMULECT BioTech Basiliximab - 20mg 20mg Injectable powder + solvent 137,661,787 L.L
L04AB06 SIMPONI BioTech Golimumab - 100mg/1ml 100mg/1ml Injectable solution 75,598,955 L.L
L04AB06 SIMPONI BioTech Golimumab - 50mg/0.5ml 50mg/0.5ml Injectable solution 75,598,955 L.L
L04AA27 SCLEMOD G Fingolimod Hydrochloride - 0.5mg 0.5mg Capsule 17,079,643 L.L
L04AA27 SCLEMOD G Fingolimod Hydrochloride - 0.5mg 0.5mg Capsule 18,264,981 L.L
L04AA10 SIROMUNE G Sirolimus - 1mg 1mg Tablet, film coated 18,729,193 L.L
L03AX03 SII-ONCO-BCG G Bacillus Calmette- Guerin Strain - 40mg/ml (1-8x10?CFU) 40mg/ml Injectable dry powder 6,987,981 L.L
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