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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
M03BB53 PARAXONE-JPI G Paracetamol - 300mg, Chlorzoxazone - 250mg Capsule 334,617 L.L
N06DA03 RIVASTIGMINE ARROW G Rivastigmine - 3mg 3mg Capsule 842,589 L.L
C08CA01 AMLODIPINE BIOGARAN G Amlodipine (besylate) - 10mg 10mg Capsule 462,282 L.L
L04AD02 PROGRAF 5MG B Tacrolimus - 5mg 5mg Capsule 94,286,686 L.L
M03BB53 RELAXON G Paracetamol - 300mg, Chlorzoxazone - 250mg Capsule 296,989 L.L
N06DA03 RIVASTIGMINE ARROW G Rivastigmine - 3mg 3mg Capsule 842,589 L.L
L01EA03 TASIGNA B Nilotinib - 200mg 200mg Capsule L.L
L04AD02 TACROGRAF 5 G Tacrolimus - 5mg 5mg Capsule 67,507,154 L.L
N06DA03 RIVASTIGMINE ARROW G Rivastigmine - 1.5mg 1.5mg Capsule 684,016 L.L
L02BB04 ENZASTIK 40 G Enzalutamide - 40mg 40mg Capsule L.L
L04AD02 PROGRAF 0.5 MG B Tacrolimus - 0.5mg 0.5mg Capsule 13,942,481 L.L
N06DA03 RIVASTIGMINE ARROW G Rivastigmine - 1.5mg 1.5mg Capsule 684,016 L.L
L04AD02 PROGRAF 0.5 MG B Tacrolimus - 0.5mg 0.5mg Capsule 13,942,481 L.L
J01DD15 OMNICEF B Cefdinir - 300mg 300mg Capsule 2,238,842 L.L
L04AD02 TACROGRAF 0.5 G Tacrolimus - 0.5mg 0.5mg Capsule 7,004,024 L.L
J01DD15 OMNICEF 300 B Cefdinir - 300mg 300mg Capsule 2,238,842 L.L
J01DD15 MINOCET G Cefdinir - 300mg 300mg Capsule 1,407,003 L.L
N02BE51 HUMEXLIB PARACETAMOL CHLORPHENAMINE B Paracetamol - 500mg, Chlorphenamine maleate - 4mg Capsule 598,010 L.L
N06DA03 RIVASTIGMINE ARROW G Rivastigmine - 4.5mg 4.5mg Capsule 842,589 L.L
J01DD15 SEFARIN G Cefdinir - 300mg 300mg Capsule 1,494,353 L.L
N06DA03 RIVASTIGMINE ARROW G Rivastigmine - 4.5mg 4.5mg Capsule 842,589 L.L
J01DD15 XEVANEER G Cefdinir - 300mg 300mg Capsule 1,350,562 L.L
N06DA52 EXENTAZIL G Donepezil - 10mg, Memantine - 28mg Capsule 4,363,009 L.L
N06DA52 MEXAZIL XR 28/10 G Memantine HCl - 28mg, Donepezil HCl - 10mg Capsule 4,333,444 L.L
L04AX02 THALIDOMIDE BMS B Thalidomide - 50mg 50mg Capsule 27,387,764 L.L
N02BF02 LYRICA B Pregabalin - 150mg 150mg Capsule 3,041,116 L.L
N06DA52 EXENTAZIL G Donepezil - 10mg, Memantine - 14mg Capsule 3,117,715 L.L
L04AX02 THALIDOMIDE CELGENE B Thalidomide - 50mg 50mg Capsule 27,387,764 L.L
N02BF02 LYRICA B Pregabalin - 150mg 150mg Capsule 3,041,116 L.L
N06DA52 MEXAZIL XR 14/10 G Memantine HCl - 14mg, Donepezil HCl - 10mg Capsule 3,432,174 L.L
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