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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
C09AA05 TRITACE B Ramipril - 10mg 10mg Tablet 689,391 L.L
C09AA05 TRILTEC G Ramipril - 10mg 10mg Capsule 575,933 L.L
L01FX24 TECVAYLI BioTech Teclistamab - 10mg/ml 10mg/ml Injectable solution 95,166,436 L.L
S01FA06 TROPICIL TOP G Tropicamide - 10mg/ml 10mg/ml Drops solution 200,233 L.L
B01AC17 TIROPREST G Tirofiban - 12.5mg/50ml 12.5mg/50ml Injectable concentrate for solution 18,279,605 L.L
L01FF05 TECENTRIQ BioTech Atezolizumab - 1200mg 1200mg Injectable concentrate for solution L.L
L01FF05 TECENTRIQ BioTech Atezolizumab - 1200mg 1200mg Injectable concentrate for solution 375,054,619 L.L
L01FF05 TECENTRIQ BioTech Atezolizumab - 1200mg 1200mg Injectable concentrate for solution 375,054,619 L.L
C02KX01 TRACLEER B Bosentan (monohydrate) - 125mg 125mg Tablet, film coated 79,583,961 L.L
C02KX01 TRACLEER B Bosentan (monohydrate) - 125mg 125mg Tablet, film coated 79,583,961 L.L
C02KX01 TRACTAN G Bosentan (monohydrate) - 125mg 125mg Tablet, film coated 47,747,570 L.L
R01AD08 TICANASE G Fluticasone propionate - 50mcg/actuation 12g/Bottle Spray, suspension 405,840 L.L
L04AA31 TERAGIO G Teriflunomide - 14mg 14mg Tablet 49,451,224 L.L
L04AA31 TERAGIO G Teriflunomide - 14mg 14mg Tablet 23,076,914 L.L
L04AA31 TERAGIO G Teriflunomide - 14mg 14mg Tablet L.L
L01EA03 TASIGNA B Nilotinib - 150mg 150mg Capsule 323,961,910 L.L
L01EB02 TARESSA 150 G Erlotinib (HCl) - 150mg 150mg Tablet, film coated 98,617,813 L.L
N02AX02 TRAMAL RETARD B Tramadol HCl - 150mg 150mg Tablet, modified release 356,118 L.L
L01FD01 TRAZIMERA BioTech Trastuzumab - 150mg 150mg Injectable powder for solution 28,550,630 L.L
L01EA03 TASIGNA B Nilotinib - 150mg 150mg Capsule L.L
C09CA03 TABUVAN G Valsartan - 160mg 160mg Tablet, film coated 544,256 L.L
N05AX13 TREVICTA B Paliperidone - 175mg 175mg Injectable suspension, prolonged release 35,006,953 L.L
L01FF05 TECENTRIQ BioTech Atezolizumab - 1875mg/15ml 1875mg/15ml Injectable solution 375,054,619 L.L
R03BB04 TIOVA-T G Tiotropium bromide monohydrate - 18mcg 18mcg Rotacaps 384,339 L.L
J01DD04 TRAVILAN IM G Ceftriaxone (sodium) - 1g 1g Injectable lyophilised powder for solution+diluent 438,093 L.L
J01DD04 TRIAXONE G Ceftriaxone (sodium) - 1g 1g Injectable powder for solution 438,093 L.L
J01DD04 TRIAXONE G Ceftriaxone (sodium) - 1g 1g Injectable powder for solution 4,542,188 L.L
L04AD02 TACROGRAF 1 G Tacrolimus - 1mg 1mg Capsule 12,679,940 L.L
L01XK04 TALZENNA B Talazoparib - 1mg 1mg Capsule 401,512,167 L.L
D06AX08 TYROSUR G Tyrothricin - 1mg/g 1mg/g Gel 510,660 L.L
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