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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
B01AF01 XARELTO B Rivaroxaban - 2.5mg 2.5mg Tablet, film coated 4,045,168 L.L
B01AF01 XARELTO B Rivaroxaban - 15mg 15mg Tablet, film coated 4,440,862 L.L
B01AF01 XARELTO B Rivaroxaban - 20mg 20mg Tablet, film coated 4,440,862 L.L
L04AA29 XELJANZ B Tofacitinib - 5mg 5mg Tablet L.L
B01AF01 XARELTO B Rivaroxaban - 10mg 10mg Tablet, film coated 1,588,892 L.L
L02BB04 XTANDI B Enzalutamide - 40mg 40mg Capsule, soft 278,248,572 L.L
N05BA12 XANAX B Alprazolam - 0.5mg 0.5mg Tablet 477,064 L.L
L01ED01 XALKORI B Crizotinib - 250mg 250mg Capsule 347,644,061 L.L
L01ED01 XALKORI B Crizotinib - 200mg 200mg Capsule 347,644,061 L.L
A08AB01 XENICAL B Orlistat - 120mg 120mg Capsule 4,036,903 L.L
G04CA01 XATRAL XL B Alfuzosin HCl - 10mg 10mg Tablet, prolonged release 1,061,636 L.L
R06AE09 XYZAL B Levocetirizine dihydrochloride - 5mg 5mg Tablet, film coated 572,477 L.L
L04AA29 XELJANZ B Tofacitinib - 5mg 5mg Tablet 80,685,473 L.L
L04AA29 XELJANZ XR B Tofacitinib - 11mg 11mg Tablet, extended release 78,687,316 L.L
L01BC06 XELODA B Capecitabine - 500mg 500mg Tablet, film coated 17,946,398 L.L
D04AB01 XYLOCAINE B Lidocaine - 10mg/spray dose 100mg/ml Spray 667,890 L.L
L01ED01 XALKORI B Crizotinib - 250mg 250mg Capsule L.L
A10BD15 XIGDUO XR B Metformin HCl XR - 1000mg, Dapagliflozin - 5mg Tablet 3,867,041 L.L
S01ED51 XALACOM B Timolol (maleate) - 6.8mg/ml, Latanoprost - 50?g/ml Drops solution 510,660 L.L
A10BD15 XIGDUO XR B Metformin HCl XR - 1000mg, Dapagliflozin - 10mg Tablet 3,006,579 L.L
S01EE01 XALATAN B Latanoprost - 50mcg/ml 50mcg/ml Drops solution 704,173 L.L
R03DX05 XOLAIR BioTech Omalizumab - 150mg 150mg Injectable lyophilised powder for solution+diluent 54,613,625 L.L
R03DX05 XOLAIR BioTech Omalizumab - 150mg 150mg Injectable solution 37,110,724 L.L
M05BX04 XGEVA BioTech Denosumab - 120mg 120mg Injectable solution 33,545,669 L.L
B02BD02 XYNTHA BioTech Moroctocog alfa - 500IU 500IU Injectable lyophilised powder for solution+diluent L.L
B02BD02 XYNTHA BioTech Moroctocog alfa - 500IU 500IU Injectable lyophilised powder for solution+diluent 23,067,288 L.L
A10AE56 XULTOPHY BioTech Insulin degludec - 100U/ml, Liraglutide - 3.6mg/ml Injectable solution 13,503,847 L.L
A10AE56 XULTOPHY BioTech Insulin degludec - 100U/ml, Liraglutide - 3.6mg/ml Injectable solution 13,503,847 L.L
B02BD02 XYNTHA BioTech Moroctocog alfa - 500IU 500IU Injectable lyophilised powder for solution+diluent L.L
M03AX01 XEOMIN BioTech Clostridium botulinum type A neurotoxin complex - 100 units LD50 100 units LD50 Injectable powder for solution 20,517,541 L.L
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