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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
L01BC06 CAPEDA G Capecitabine - 500mg 500mg Tablet, film coated 4,927,423 L.L
J01DE01 CEFIPEX 500 BENTA G Cefepime (hydrochloride) - 500mg 500mg Injectable solution 545,216 L.L
J05AB06 CYMEVENE B Ganciclovir (sodium) - 500mg 500mg Injectable solution 1,726,838 L.L
L01XX05 CUREAML G Hydroxycarbamide (or Hydroxyurea) - 500mg 500mg Capsule 1,228,272 L.L
L01XX05 CYTODROX G Hydroxycarbamide (or Hydroxyurea) - 500mg 500mg Capsule 3,301,821 L.L
J01GB06 CHEMACIN G Amikacin (sulfate) - 500mg/2ml 500mg/2ml Injectable solution 1,679,803 L.L
L01FG02 CYRAMZA BioTech Ramucirumab - 500mg/50ml 500mg/50ml Injectable solution L.L
L01FG02 CYRAMZA BioTech Ramucirumab - 500mg/50ml 500mg/50ml Injectable solution 218,656,548 L.L
G03GB02 CLOMID B Clomifene citrate - 50mg 50mg Tablet 274,144 L.L
G03GB02 CLOMIFERT G Clomifene citrate - 50mg 50mg Tablet 395,090 L.L
G03GB02 CLOMIFERT G Clomifene citrate - 50mg 50mg Tablet 395,090 L.L
L02BB03 CASODEX B Bicalutamide - 50mg 50mg Tablet, film coated 3,777,541 L.L
C09CA01 COZAAR B Losartan potassium - 50mg 50mg Tablet 1,420,634 L.L
M01AB05 CATAFLAM B Diclofenac potassium - 50mg 50mg Tablet, sugar coated 262,049 L.L
N05AA01 CHLORPROMAZINE G Chlorpromazine HCl - 50mg 50mg Tablet 332,761 L.L
J02AX04 CANCIDAS B Caspofungin (acetate) - 50mg 50mg Injectable concentrated powder for solution 25,799,521 L.L
J02AX04 CANDIGARD G Caspofungin (acetate) - 50mg 50mg Injectable powder for concentrate for solution 22,127,179 L.L
J02AX04 CASPOFUNGINE STRAGEN G Caspofungin (acetate) - 50mg 50mg Injectable concentrated powder for solution 18,712,833 L.L
C09AA01 CAPTACE G Captopril - 50mg 50mg Tablet, scored 652,724 L.L
L01XA01 CIPINTU G Cisplatin - 50mg/50ml 50mg/50ml Injectable concentrated solution 1,206,771 L.L
L01XA01 CISPLATINE VIATRIS 1MG/ML G Cisplatin - 50mg/50ml 50mg/50ml Injectable concentrated solution 1,179,655 L.L
J01DD13 CEFODOX G Cefpodoxime (proxetil) - 50mg/5ml 50mg/5ml Powder for suspension 604,729 L.L
L01XA02 CARBOPLATINE VIATRIS 10MG/ML G Carboplatin - 50mg/5ml 50mg/5ml Injectable solution 941,930 L.L
D06BB03 CYCLOVEX G Aciclovir - 50mg/g 50mg/g Cream 345,560 L.L
N03AG01 CONVULEX G Sodium Valproate - 50mg/ml 50mg/ml Syrup 213,671 L.L
N06BA04 CONCERTA B Methylphenidate HCl - 54mg 54mg Tablet, extended release 6,049,979 L.L
S02D CERULYSE B Xylene - 5g/100g 5g/100g Drops solution 339,992 L.L
J06BA02 CLAIRYG BioHuman Human normal immunoglobulin G - 50mg/ml 5g/100ml Injectable solution 42,296,819 L.L
J06BA02 CLAIRYG BioHuman Human normal immunoglobulin G - 50mg/ml 5g/100ml Injectable solution L.L
R06AE09 CALIVIDA G Levocetirizine dihydrochloride - 5mg 5mg Tablet, film coated 447,948 L.L
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