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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
B05XA PEDITRACE B Sodium selenite 5H2O (anhydrous) - 6.66mcg/ml, Sodium fluoride - 126mcg/ml, Potassium iodide - 1.31mcg/ml, Zinc chloride - 521mcg/ml, Copper chloride - 53.7mcg/ml, Manganese chloride 4H2O - 3.6mcg/ml Injectable concentrated solution 4,749,139 L.L
L01CD01 PANATAXEL G Paclitaxel - 30mg/5ml 30mg/5ml Injectable concentrated solution 3,563,870 L.L
L01CD01 PANATAXEL G Paclitaxel - 100mg/16.7ml 100mg/16.7ml Injectable concentrated solution 7,071,670 L.L
L01CD01 PANATAXEL G Paclitaxel - 150mg/25ml 150mg/25ml Injectable concentrated solution 16,521,761 L.L
C01EA01 PROSTIN VR B Alprostadil - 500mcg/ml 500mcg/ml Injectable concentrated solution 19,894,577 L.L
L01BA04 PEMETREXED SPC G Pemetrexed (disodium) - 500mg 500mg Injectable concentrated powder for solution 43,746,515 L.L
L01CD01 PACLITAXEL MYLAN PHARMA 6MG/ML G Paclitaxel - 300mg/50ml 300mg/50ml Injectable concentrated powder for solution 52,787,940 L.L
L01CD01 PACLITAXEL MYLAN PHARMA 6MG/ML G Paclitaxel - 30mg/5ml 30mg/5ml Injectable concentrated powder for solution 5,923,692 L.L
L01CD01 PACLITAXEL MYLAN PHARMA 6MG/ML G Paclitaxel - 100mg/16.7ml 100mg/16.7ml Injectable concentrated powder for solution 22,410,062 L.L
J05AX18 PREVYMIS B Letermovir - 240mg/12ml 240mg/12ml Injectable concentrate for solution 23,599,640 L.L
N05CM18 PROXIDA G Dexmedetomidine HCl - 200mcg/2ml 200mcg/2ml Injectable concentrate for solution 1,771,184 L.L
L01FD02 PERJETA 420MG BioTech Pertuzumab - 420mg/14ml 420mg/14ml Injectable concentrate for solution L.L
L01BA04 PEMETREXED EVER PHARMA G Pemetrexed (disodium) - 500mg/20ml 500mg/20ml Injectable concentrate for solution 38,618,714 L.L
L01BA04 PEMETREXED STRAGEN G Pemetrexed (disodium) - 500mg/20ml 500mg/20ml Injectable concentrate for solution 24,037,602 L.L
L01BA04 PEMETREXED STRAGEN G Pemetrexed (disodium) - 1000mg/40ml 1000mg/40ml Injectable concentrate for solution 40,480,209 L.L
L01BA04 PEMETREXED EVER PHARMA G Pemetrexed (disodium) - 100mg/4ml 100mg/4ml Injectable concentrate for solution 12,185,492 L.L
L01BA04 PEMETREXED STRAGEN G Pemetrexed (disodium) - 100mg/4ml 100mg/4ml Injectable concentrate for solution 12,759,187 L.L
L01FD02 PERJETA 420MG BioTech Pertuzumab - 420mg/14ml 420mg/14ml Injectable concentrate for solution 220,054,714 L.L
L01FD02 PERTUVIA BioTech Pertuzumab - 420mg/14ml 420mg/14ml Injectable concentrate for solution 147,592,404 L.L
L01CD01 PATAXEL G Paclitaxel - 300mg/50ml 300mg/50ml Injectable concentrate for solution 17,809,220 L.L
L01CD01 PACLITAXEL NEAPOLIS G Paclitaxel - 30mg 30mg Injectable concentrate for solution 3,514,148 L.L
L01CD01 PATAXEL G Paclitaxel - 30mg/5ml 30mg/5ml Injectable concentrate for solution 2,447,137 L.L
L01CD01 PATAXEL G Paclitaxel - 100mg/16.7ml 100mg/16.7ml Injectable concentrate for solution 8,500,054 L.L
L01CD01 PACLITAXEL NEAPOLIS G Paclitaxel - 150mg/25ml 150mg/25ml Injectable concentrate for solution 15,665,972 L.L
R03BA02 PULMICORT B Budesonide - 0.5mg/ml 0.5mg/ml Inhalation suspension for nebuliser 2,015,764 L.L
R05CB13 PULMOZYME BioTech Dornase alfa (desoxyribonuclease) - 2.5mg/2.5ml 2.5mg/2.5ml Inhalation solution L.L
R05CB13 PULMOZYME BioTech Dornase alfa (desoxyribonuclease) - 2.5mg/2.5ml 2.5mg/2.5ml Inhalation solution 54,658,804 L.L
R03AK06 PROPIONATE DE FLUTICASONE/ SALMETEROL ARROW G Salmeterol - 50mcg/dose, Fluticasone propionate - 100mcg/dose Inhalation powder 1,593,797 L.L
R03AK06 PROPIONATE DE FLUTICASONE/ SALMETEROL ARROW G Salmeterol - 50mcg/dose, Fluticasone propionate - 250mcg/dose Inhalation powder 1,980,824 L.L
R03AK06 PROPIONATE DE FLUTICASONE/ SALMETEROL ARROW G Salmeterol - 50mcg/dose, Fluticasone propionate - 500mcg/dose Inhalation powder 2,605,711 L.L
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