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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
H05BX01 CINACALCET ARROW BioTech Cinacalcet - 30mg 30mg Tablet, coated 8,768,039 L.L
C09CA06 CANDESARTAN BIOGARAN G Candesartan cilexetil - 32mg 32mg Tablet, scored 434,061 L.L
C01EB15 CARMETADIN G Trimetazidine - 35mg 35mg Tablet, film coated, modified release 631,606 L.L
N06BA04 CONCERTA B Methylphenidate HCl - 36mg 36mg Tablet, extended release 4,393,021 L.L
S01AE03 CILOXAN B Ciprofloxacine (HCl) - 3mg/ml 3mg/ml Drops solution 348,055 L.L
S02AA15 CETRAXAL OTICO G Ciprofloxacine (HCl) - 3mg/ml 3mg/ml Drops 821,088 L.L
A16AB02 CEREZYME B Imiglucerase - 400IU 400IU Injectable lyophilised powder for solution L.L
A16AB02 CEREZYME B Imiglucerase - 400IU 400IU Injectable lyophilised powder for solution 128,412,818 L.L
M01AE01 CAPTAIN FORTE G Ibuprofen - 400mg 400mg Capsule, soft gelatin 508,740 L.L
J01DD08 CEFDIA G Cefixime - 400mg 400mg Tablet, film coated 806,306 L.L
J01DD08 CEFIX G Cefixime (trihydrate) - 400mg 400mg Capsule 791,523 L.L
J05AB01 CYCLOVEX G Aciclovir - 400mg 400mg Tablet, scored 2,687,685 L.L
G03DA04 CYCLOGEST G Progesterone - 400mg 400mg Pessary 1,546,763 L.L
L01EA01 CEMIVIL G Imatinib - 400mg 400mg Tablet, film coated 41,106,321 L.L
J01MA02 CEFLOXINE G Ciprofloxacin - 400mg/200ml 400mg/200ml Injectable solution 1,134,203 L.L
J01MA02 CIPROFLOXACINE PANPHARMA G Ciprofloxacine (HCl) - 400mg/200ml 400mg/200ml Injectable solution 9,908,924 L.L
J01MA02 CIPROFLOXACINE PANPHARMA G Ciprofloxacine (HCl) - 400mg/200ml 400mg/200ml (2mg/ml) Injectable solution 9,908,924 L.L
C10AA07 CRESTOR B Rosuvastatin (calcium) - 40mg 40mg Tablet, film coated 804,962 L.L
D10BA01 CONTRACNE ISOTRETINOINE G Isotretinoin - 40mg 40mg Capsule, soft 3,043,803 L.L
D10BA01 CURACNE G Isotretinoin - 40mg 40mg Capsule, soft gelatin 3,553,120 L.L
D10BA01 CURACNE G Isotretinoin - 40mg 40mg Capsule, soft gelatin 3,553,120 L.L
D10BA01 CURACNE G Isotretinoin - 40mg 40mg Capsule, soft gelatin 3,553,120 L.L
D10BA01 CURACNE G Isotretinoin - 40mg 40mg Capsule, soft gelatin 3,553,120 L.L
L01EX07 CABOMETYX B Cabozantinib - 40mg 40mg Tablet, film coated 440,893,501 L.L
L04AB04 CINNORA BioTech Adalimumab - 40mg/0.8ml 40mg/0.8ml Injectable solution 14,817,734 L.L
G03GA05 CINNAL-f BioHuman Follitropin alfa - 450IU/0.75ml 450IU/0.75ml Injectable solution 7,372,177 L.L
C02CA04 CARDULAR B Doxazosin (mesylate) - 4mg 4mg Tablet 755,239 L.L
C02CA04 CURCARD G Doxazosin (mesylate) - 4mg 4mg Tablet 452,875 L.L
C01DX12 CORVASAL 4MG B Molsidomine - 4mg 4mg Tablet 492,742 L.L
D06BA02 CREM-O-SULFA G Sulfathiazole - 5% 5% Cream 202,216 L.L
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