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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
A10BD07 SITAMET G Metformin - 1000mg, Sitagliptin - 50mg Tablet, film coated 2,541,715 L.L
B01AC04 PIDOGREL MEDIS G Clopidogrel - 75mg 75mg Tablet, film coated 810,337 L.L
B05BB02 MIXTE SIMPLE (1) G Sodium chloride - 0.45g/100ml, Dextrose, H2O - 5g/100ml Injectable solution 205,933 L.L
C01CA06 PHENYLEPHRINE RENAUDIN G Phenylephrine - 100mcg/ml 100mcg/ml Injectable solution 5,955,910 L.L
C09DX01 VIOSTAN AM PLUS 160/5/12.5 G Valsartan - 160mg, Amlodipine - 5mg, Hydrochlorothiazide - 12.5mg Tablet, film coated 1,196,020 L.L
D05AX52 BETA-CAL G Calcipotriol (monohydrate) - 50mcg/g, Betamethasone (dipropionate) - 0.5mg/g Ointment 1,574,983 L.L
J05AB01 LOVRAK-JULPHAR G Aciclovir - 250mg 250mg Injectable lyophilised powder 278,175 L.L
L01CD01 EBETAXEL G Paclitaxel - 150mg/25ml 150mg/25ml Injectable concentrated solution 15,457,059 L.L
L01XA02 CARBOPLATINE VIATRIS 10MG/ML G Carboplatin - 150mg/15ml 150mg/15ml Injectable solution 2,981,283 L.L
L04AX03 METOJECT G Methotrexate disodium - 25mg/0.5ml 25mg/0.5ml Injectable solution 2,582,865 L.L
M04AA01 ALLOPURINOL BIOGARAN G Allopurinol - 300mg 300mg Tablet 212,327 L.L
N02BF02 PREGAFORTE 150 G Pregabalin - 150mg 150mg Capsule 1,023,880 L.L
N05AN01 MANICARB SR-400 G Lithium carbonate - 400mg 400mg Tablet, prolonged release 1,431,192 L.L
R05 COQUELUSEDAL NOURRISSON G Grindelia extract - 10mg, Gelsenium extract - 5mg Suppository 515,819 L.L
S01GA01 IRIDINA DUE G Naphazoline HCl - 0.5mg/ml 0.5mg/ml Drops solution 469,001 L.L
A04AA01 ONDANSETRON VIANEX G Ondansetron (HCl) - 8mg/4ml 8mg/4ml Injectable solution 387,027 L.L
A10BD07 SITAVITEA PLUS G Metformin - 1000mg, Sitagliptin - 50mg Tablet, film coated 1,079,106 L.L
B01AC04 PLAVINOR-75 G Clopidogrel - 75mg Tablet, film coated Tablet, film coated 1,112,702 L.L
B05BB02 SERUFLEX DEXTROSE 5% SODIUM CHLORIDE 0.45% INJECTION, USP G Sodium chloride - 0.45%, Glucose - 5% Injectable solution 193,062 L.L
C01CA06 PHENYLEPHRINE AGUETTANT G Phenylephrine - 500mcg/10ml 500mcg/10ml Injectable solution 11,464,796 L.L
C08DB01 APO-DILTIAZ G Diltiazem HCl - 60mg 60mg Tablet 545,600 L.L
C09DX01 ANGIOSAR PLUS G Valsartan - 320mg, Amlodipine - 10mg, Hydrochlorothiazide - 25mg Tablet, film coated 1,689,210 L.L
D05AX52 ROLIP G Calcipotriol - 50mcg, Betamethasone - 0.5mg Ointment 1,574,983 L.L
J01DH02 ARCHIFAR G Meropenem - 500mg 500mg Injectable powder for solution 6,443,725 L.L
L01CD01 PACLITAXEL NEAPOLIS G Paclitaxel - 150mg/25ml 150mg/25ml Injectable concentrate for solution 15,665,972 L.L
L01XA02 CARPLATU G Carboplatin - 150mg/15ml 150mg/15ml Injectable solution 1,277,994 L.L
M04AA01 ALURIC G Allopurinol - 300mg 300mg Tablet, scored 175,339 L.L
N06DX01 MEMANTINE ARROW LAB G Memantine HCl - 20mg 20mg Tablet, film coated 1,342,499 L.L
R05 EXALL FORTE G Chlorpheniramine maleate - 2.5mg, Guaifenesin - 100mg, Acetaminophen - 100mg, Diprophylline - 25mg Syrup 501,701 L.L
S01GA04 ALERJON G Oxymetazoline HCl - Drops solution 528,130 L.L
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