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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
L01CD01 PACLITAXEL MYLAN PHARMA 6MG/ML G Paclitaxel - 30mg/5ml 30mg/5ml Injectable concentrated powder for solution 5,923,692 L.L
N05AH04 REZAL XR G Quetiapine fumarate - 50mg 50mg Tablet, extended release 533,505 L.L
N06DA52 EXENTAZIL G Donepezil - 10mg, Memantine - 14mg Capsule 3,117,715 L.L
S01EE04 TRAVOPROST BIOGARAN G Travoprost - 40mcg/ml 40mcg/ml Drops solution 564,414 L.L
A04AA01 ONDANSETRON VIANEX G Ondansetron (HCl) - 4mg/2ml 4mg/2ml Injectable solution 197,545 L.L
B01AC04 CLOPIKEY G Clopidogrel (Bisulfate) - 75mg 75mg Tablet 748,520 L.L
B05BB02 DEXTROSE 5% & SODIUM CHLORIDE 0.45% G Sodium chloride - 0.45g/100ml, Dextrose, H2O - 5g/100ml Injectable solution 217,210 L.L
C01CA03 NORADRENALINE RENAUDIN G Norepinephrine tartrate - 8mg/4ml 0.2% Injectable solution 2,000,981 L.L
C09DX01 VIOSTAN AM PLUS 160/10/12.5 G Valsartan - 160mg, Amlodipine - 10mg, Hydrochlorothiazide - 12.5mg Tablet, film coated 1,196,020 L.L
D04AB01 LIDONOSTRUM G Lidocaine - 50mg/g 50mg/g Ointment 1,069,699 L.L
J01DE01 CEFIPEX 500 BENTA G Cefepime (hydrochloride) - 500mg 500mg Injectable solution 545,216 L.L
J02AX05 MEGMENTO G Micafungin (sodium) - 50mg 50mg Injectable powder for solution 9,530,364 L.L
L01CD01 PACLITAXEL NEAPOLIS G Paclitaxel - 30mg 30mg Injectable concentrate for solution 3,514,148 L.L
M03BX04 STIFFANO G Tolperisone - 150mg 150mg Tablet 651,764 L.L
N05AH04 JOSWE QUZAL 400 G Quetiapine - 400mg 400mg Tablet 2,697,092 L.L
N06DA52 MEXAZIL XR 14/10 G Memantine HCl - 14mg, Donepezil HCl - 10mg Capsule 3,432,174 L.L
R03DC03 AIRFAST PEDIATRICS G Montelukast (sodium) - 4mg 4mg Granules for solution 880,217 L.L
S01EE05 TAFLUPRO G Tafluprost - 0.0015% 0.0015% Solution 1,912,288 L.L
A04AA01 TRONDAMET G Ondansetron (HCl) - 4mg/2ml 4mg/2ml Injectable solution 2,027,858 L.L
B01AC04 CLOTRIX 75 G Clopidogrel (hydrogenosulfate) - 75mg 75mg Tablet, film coated 1,109,630 L.L
B05BB02 DEXTROSE 5% & SODIUM CHLORIDE 0.45% G Sodium chloride - 0.45g/100ml, Dextrose, H2O - 5g/100ml Injectable solution 240,255 L.L
C01CA03 α NORADRENALINE G Norepinephrine tartrate - 8mg/4ml 8mg/4ml Injectable solution 330,201 L.L
J01DE01 CEFEPIME LDP LABORATORIOS TORLAN G Cefepime - 1g 1g Injectable powder for solution 5,933,065 L.L
J02AX05 MEGMENTO G Micafungin (sodium) - 100mg 100mg Injectable powder for solution 17,158,569 L.L
L01CD01 PANATAXEL G Paclitaxel - 30mg/5ml 30mg/5ml Injectable concentrated solution 3,563,870 L.L
L01XA01 CISPLATINE VIATRIS 1MG/ML G Cisplatin - 10mg/10ml 10mg/10ml Injectable concentrated solution 412,655 L.L
L04AX03 EBETREXAT G Methotrexate - 5mg 5mg Tablet, scored 2,488,796 L.L
M03BX08 JAMP-CYCLOBENZAPRINE G Cyclobenzaprine HCl - 10mg 10mg Tablet 4,031,528 L.L
N02BF02 GABRIKA 150 G Pregabalin - 150mg 150mg Capsule 819,104 L.L
N05AH04 JOSWE QUZAL 400 G Quetiapine - 400mg 400mg Tablet 5,124,071 L.L
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