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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
C09BA04 PRETERAX ARGININE B Perindopril arginine - 2.5mg, Indapamide - 0.625mg Tablet, film coated 452,875 L.L
J01FA09 RITHROCID G Clarithromycin - 500mg 500mg Tablet, film coated 686,704 L.L
J05AP08 NUCLEOBUVIR G Sofosbuvir - 400mg 400mg Tablet, film coated 50,670,440 L.L
L01EA01 IMATINIB NEAPOLIS G Imatinib - 400mg 400mg Tablet, film coated 36,046,335 L.L
A10BD20 SYNJARDY B Empagliflozin - 5mg, Metformin HCl - 1000mg 5mg/1000mg Tablet, film coated 3,399,653 L.L
B01AF01 RIBAVAN G Rivaroxaban - 20mg 20mg Tablet, film coated 1,343,843 L.L
C02AC05 CYNT B Moxonidine - 0.4mg 0.4mg Tablet, film coated 1,266,372 L.L
C09BA04 BI-PRETERAX ARGININE B Perindopril arginine - 10mg, Indapamide - 2.5mg Tablet, film coated 765,990 L.L
J05AP55 EPCLUSA B Sofosbuvir - 400mg, Velpatasvir - 100mg Tablet, film coated 991,921,769 L.L
L01EA01 IMATINIB SHILPA MESYLATE G Imatinib - 400mg 400mg Tablet, film coated 21,518,059 L.L
A10BD20 EMPAZIMET G Metformin HCl - 1000mg, Empagliflozin - 5mg Tablet, film coated 1,840,168 L.L
B01AF01 RIXALTA 20 G Rivaroxaban - 20mg 20mg Tablet, film coated 1,164,664 L.L
C10AA05 LIPODAR G Atorvastatin (calcium) - 10mg 10mg Tablet, film coated 1,323,685 L.L
J05AP56 VOSEVI B Sofosbuvir - 400mg, Velpatasvir - 100mg, Voxilaprevir - 100mg Tablet, film coated 891,634,849 L.L
L01EA01 IMATINIB SPC G Imatinib - 400mg 400mg Tablet, film coated 62,161,280 L.L
M05BX OSSOPAN B Osseine-hydroxyapatite complex - 800mg 800mg Tablet, film coated 1,142,266 L.L
A10BD20 FLORIMET 5/1000 G Metformin - 1000mg, Empagliflozin - 5mg Tablet, film coated 1,836,585 L.L
B01AF01 VAROXA G Rivaroxaban - 20mg 20mg Tablet, film coated 1,343,843 L.L
C10AA05 LIPONORM G Atorvastatin (calcium) - 10mg 10mg Tablet, film coated 967,567 L.L
J05AR01 CONDINE G Lamivudine - 150mg, Zidovudine - 300mg Tablet, film coated 5,818,474 L.L
A10BD21 ENFORZA B Saxagliptin HCl - 5mg, Dapagliflozin - 10mg Tablet, film coated 6,072,824 L.L
B01AF01 XAVIRAN G Rivaroxaban - 20mg 20mg Tablet, film coated 952,208 L.L
C09BB02 ZANIPRESS B Lercanidipine HCl - 10mg, Enalapril maleate - 20mg Tablet, film coated 2,548,821 L.L
C10AA05 LORVAST G Atorvastatin (calcium) - 10mg 10mg Tablet, film coated 1,114,045 L.L
L01EA01 GLIVEC B Imatinib (mesylate) - 100mg 100mg Tablet, film coated 50,531,993 L.L
B01AF01 ZARLAN G Rivaroxaban - 20mg 20mg Tablet, film coated 1,343,843 L.L
C09BB02 ZANIPRESS B Lercanidipine HCl - 10mg, Enalapril maleate - 10mg Tablet, film coated 2,280,949 L.L
G04BD02 URISPAS B Flavoxate HCl - 200mg 200mg Tablet, film coated 1,094,272 L.L
J05AR03 TRUVADA B Emtricitabine - 200mg, Tenofovir disoproxil - 245mg Tablet, film coated 21,319,383 L.L
B01AF01 XARELTO B Rivaroxaban - 10mg 10mg Tablet, film coated 1,588,892 L.L
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