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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
L01FD01 ARYOTRUST BioTech Trastuzumab - 150mg 150mg Injectable powder for concentrate for solution 21,176,745 L.L
L01FG01 AVASTIN BioTech Bevacizumab - 400mg/16ml 400mg/16ml Injectable concentrated solution 75,875,312 L.L
L01FG01 AVASTIN BioTech Bevacizumab - 400mg 400mg Injectable concentrated solution 75,875,312 L.L
L01FG01 AVASTIN BioTech Bevacizumab - 100mg/4ml 100mg/4ml Injectable concentrated solution 24,533,456 L.L
L01FG01 AVASTIN BioTech Bevacizumab - 100mg 100mg Injectable concentrated solution 24,533,456 L.L
L01FX05 ADCETRIS BioTech Brentuximab Vedotin - 50mg 50mg Injectable powder for concentrate for solution 298,266,862 L.L
L01XG01 ALVOCADE G Bortezomib - 3.5mg 3.5mg Injectable powder for solution 14,169,600 L.L
L01XK52 AKEEGA B Niraparib - 100mg, Abiraterone acetate - 500mg Tablet, film coated 519,366,124 L.L
L01XK52 AKEEGA B Niraparib - 50mg, Abiraterone acetate - 500mg Tablet, film coated 519,366,124 L.L
L01XX35 ANAGRELIDE BIOGARAN G Anagrelide - 0.5mg 0.5mg Capsule 15,754,068 L.L
L02BG03 ARIMIDEX B Anastrozole - 1mg 1mg Tablet, film coated 3,202,377 L.L
L02BG03 ANASTROZOL GP PHARM G Anastrozole - 1mg 1mg Tablet, film coated 1,181,238 L.L
L02BG03 ANASTROZOLE ARROW LAB G Anastrozole - 1mg 1mg Tablet 1,552,138 L.L
L02BG03 ANASTROZOLE BIOGARAN G Anastrozole - 1mg 1mg Tablet, coated 3,800,387 L.L
L02BG03 APO-ANASTROZOLE G Anastrozole - 1mg 1mg Tablet 2,615,118 L.L
L02BG04 APO-LETROZOLE G Letrozole - 2.5mg 2.5mg Tablet 1,962,010 L.L
L02BX03 ABIRATERONE ACETATE NEAPOLIS G Abiraterone acetate - 250mg 250mg Tablet 75,418,662 L.L
L02BX03 ABIRATERONE ACETATE SPC G Abiraterone acetate - 250mg 250mg Tablet, film coated 92,278,660 L.L
L02BX03 ABLAX 250 G Abiraterone acetate - 250mg 250mg Tablet 45,056,853 L.L
L02BX03 ABREMIA G Abiraterone acetate - 250mg 250mg Tablet 77,478,802 L.L
L02BX03 ABLAX 500 G Abiraterone acetate - 500mg 500mg Tablet 45,056,853 L.L
L02BX03 APO-ABIRATERONE G Abiraterone acetate - 500mg 500mg Tablet, film coated 46,110,590 L.L
L03AB07 AVONEX BioTech Interferon beta-1a - 30mcg/0.5ml 30mcg/0.5ml Injectable solution 70,488,764 L.L
L04AA13 ARAVA B Leflunomide - 10mg 10mg Tablet, film coated 2,230,779 L.L
L04AA13 AROTAN G Leflunomide - 10mg 10mg Tablet, film coated 1,527,949 L.L
L04AA13 ARAVA B Leflunomide - 20mg 20mg Tablet, film coated 3,346,168 L.L
L04AA13 AROTAN G Leflunomide - 20mg 20mg Tablet, film coated 2,014,420 L.L
L04AA31 AUBAGIO B Teriflunomide - 14mg 14mg Tablet, film coated 38,773,533 L.L
L04AA31 AUBAGIO B Teriflunomide - 14mg 14mg Tablet, film coated 38,773,533 L.L
L04AA32 APRIVA STARTER PACK G Apremilast - 10mg, Apremilast - 20mg, Apremilast - 30mg Tablet, film coated 22,154,866 L.L
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