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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
R05X MUCOTAL PROMETHAZINE G Promethazine HCl - 2.5mg/5ml, Carbocysteine - 100mg/5ml Syrup 243,172 L.L
G04BD06 MICTONORM B Propiverine HCl - 15mg 15mg Tablet, coated 1,261,868 L.L
G04BD06 MICTONORM XL B Propiverine HCl - 30mg 30mg Capsule, modified release 1,648,895 L.L
G04BD06 MICTONORM XL B Propiverine HCl - 45mg 45mg Capsule, modified release 1,877,348 L.L
G04BD06 MICTONORM B Propiverine HCl - 5mg 5mg Tablet, coated 1,917,663 L.L
N07AA02 MESTINON B Pyridostigmine bromide - 60mg 60mg Tablet, sugar coated 3,090,838 L.L
A12CC MAGNE B6 B Pyridoxine HCl - 5mg, Magnesium lactate dihydrate - 470mg Tablet, coated 365,525 L.L
A12CC MAGNE B6 B Pyridoxine HCl - 5mg, Magnesium lactate dihydrate - 470mg Tablet, coated 365,525 L.L
M05BA07 MADRONATE G Risedronate sodium - 35mg 35mg Tablet, film coated 724,907 L.L
L01FA01 MABIXEN 100 BioTech Rituximab - 100mg/10ml 100mg/10ml Injectable concentrate for solution 22,183,393 L.L
L01FA01 MABIXEN 100 BioTech Rituximab - 100mg/10ml 100mg/10ml Injectable concentrate for solution 11,091,696 L.L
L01FA01 MABTHERA BioTech Rituximab - 100mg/10ml 100mg/10ml Injectable concentrated solution 35,722,424 L.L
L01FA01 MABIXEN 500 BioTech Rituximab - 500mg/50ml 500mg/50ml Injectable concentrate for solution 136,761,210 L.L
L01FA01 MABIXEN 500 BioTech Rituximab - 500mg/50ml 500mg/50ml Injectable concentrate for solution 74,718,320 L.L
L01FA01 MABTHERA BioTech Rituximab - 500mg/50ml 500mg/50ml Injectable concentrated solution 80,211,932 L.L
N02CC04 MAXALT B Rizatriptan (benzoate) - 10mg Tablet 439,436 L.L
J07BD52 M-M-R II (MEASLES, MUMPS AND RUBELLA VIRUS VACCINE LIVE) B Rubella virus live attenuated - , Mumps virus live attenuated - , Measles virus live attenuated - Injectable solution+diluent 12,924,401 L.L
J07BD52 MEASLES, MUMPS AND RUBELLA VACCINE LIVE ATTENUATED (FREEZE-DRIED) MMR G Rubella virus live attenuated - ?1000CCID50 /0.5ml, Mumps virus live attenuated - ?5000CCID50 /0.5ml, Measles virus live attenuated - ?1000CCID50 /0.5ml Injectable freeze dried powder + diluent 739,113 L.L
A02AF02 MAALOX PLUS B Simethicone - 25mg/5ml, Aluminium hydroxide - 175mg/5ml, Magnesium hydroxide - 200mg/5ml Suspension 438,093 L.L
L04AA42 MAYZENT B Siponimod - 0.25mg 0.25mg Tablet, film coated 15,102,158 L.L
L04AA42 MAYZENT B Siponimod - 0.25mg 0.25mg Tablet, film coated 124,258,444 L.L
L04AA42 MAYZENT B Siponimod - 2mg 2mg Tablet, film coated 124,258,444 L.L
B05BB02 MIXTE SIMPLE (1) G Sodium chloride - 0.45g/100ml, Dextrose, H2O - 5g/100ml Injectable solution 182,720 L.L
B05BB02 MIXTE SIMPLE (1) G Sodium chloride - 0.45g/100ml, Dextrose, H2O - 5g/100ml Injectable solution 205,933 L.L
B05BB02 MIXTE SIMPLE (2) G Sodium chloride - 0.9g/100ml, Dextrose, H2O - 5g/100ml Injectable solution 182,720 L.L
B05BB02 MIXTE SIMPLE (2) G Sodium chloride - 0.9g/100ml, Dextrose, H2O - 5g/100ml Injectable solution 207,894 L.L
A06AG11 MINILAX G Sodium citrate (dihydrate) - 900mg/10ml, Sodium lauryl sulfate - 150mg/10ml, Glycerol - 1200mg/10ml, Sorbic acid - 10mg/10ml, Sorbitol - 9.96mg/10ml Solution 474,824 L.L
G04CA02 MINGO G Tamsulosin - 0.4mg 0.4mg Capsule 673,201 L.L
C09CA07 MICARDIS B Telmisartan - 40mg 40mg Tablet 760,615 L.L
C09CA07 MICARDIS B Telmisartan - 80mg 80mg Tablet 998,475 L.L
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