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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
L04AD01 SANDIMMUN NEORAL SOFT GELATIN B Ciclosporin - 25mg 25mg Capsule, soft gelatin 2,385,320 L.L
L04AD01 SANDIMMUN NEORAL SOFT GELATIN B Ciclosporin - 100mg 100mg Capsule, soft gelatin 8,264,592 L.L
B01AB11 VESSEL DUE F TAB. B Sulodexide - 250LRU 250LSU Capsule, soft gelatin 2,792,505 L.L
L01CA04 NAVELBINE B Vinorelbine (ditartrate) - 20mg 20mg Capsule, soft gelatin 4,048,997 L.L
L01CA04 NAVELBINE B Vinorelbine (ditartrate) - 30mg 30mg Capsule, soft gelatin 6,072,824 L.L
G03DA04 PROGEST G Progesterone micronised - 100mg 100mg Capsule, soft gelatin 368,213 L.L
G03DA04 PROGEST 200 G Progesterone micronised - 200mg 200mg Capsule, soft gelatin 411,216 L.L
L02BB04 XTANDI B Enzalutamide - 40mg 40mg Capsule, soft 278,248,572 L.L
A11CC03 DERIL G Alfacalcidol - 1mcg 1mcg Capsule, soft 783,460 L.L
D10BA01 CONTRACNE ISOTRETINOINE G Isotretinoin - 20mg 20mg Capsule, soft 1,521,230 L.L
A11CC06 HIDROFEROL G Calcifediol - 0.266mg 0.266mg Capsule, soft 1,316,966 L.L
D10BA01 CURACNE G Isotretinoin - 5mg 5mg Capsule, soft 856,028 L.L
D10BA01 CONTRACNE ISOTRETINOINE G Isotretinoin - 40mg 40mg Capsule, soft 3,043,803 L.L
L01EX09 OFEV B Nintedanib - 100mg 100mg Capsule, soft 104,970,726 L.L
L01EX09 OFEV B Nintedanib - 150mg 150mg Capsule, soft 209,943,871 L.L
L01EX10 RYDAPT B Midostaurin - 25mg 25mg Capsule, soft 1,214,817,915 L.L
L01EX10 RYDAPT B Midostaurin - 25mg 25mg Capsule, soft 607,408,958 L.L
G04CB02 DUTASTERIDE BIOGARAN G Dutasteride - 0.5mg 0.5mg Capsule, soft 1,112,702 L.L
L01EX09 OFEV B Nintedanib - 150mg 150mg Capsule, soft L.L
G01AA51 GYNAMEND G Nystatin - 100,000IU, Neomycin (sulfate) - 35,000IU, Polymyxin B sulfate - 35,000IU Capsule, soft 345,560 L.L
B01AB11 ANGIOFLUX G Sulodexide - 250LRU 250LRU Capsule, soft 2,026,514 L.L
A03AA04 SPASMINE (Mebeverine HCl 200mg SR) G Mebeverine HCl - 200mg 200mg Capsule, slow release 712,876 L.L
M01AB05 OLFEN-100 SR G Diclofenac sodium - 100mg 100mg Capsule, prolonged release 503,941 L.L
N06AX16 DEPREVIX HELLAS G Venlafaxine - 75mg 75mg Capsule, prolonged release 564,414 L.L
N06AX16 DEPREVIX HELLAS G Venlafaxine - 75mg 75mg Capsule, prolonged release 564,414 L.L
N06AX16 VENLAFAXINE BIOGARAN LP G Venlafaxine HCl - 75mg 75mg Capsule, prolonged release 584,571 L.L
L04AD02 ADVAGRAF B Tacrolimus monohydrate - 1mg 1mg Capsule, prolonged release L.L
L04AD02 ADVAGRAF B Tacrolimus monohydrate - 3mg 3mg Capsule, prolonged release L.L
N06AX16 DEPREVIX HELLAS G Venlafaxine - 150mg 150mg Capsule, prolonged release 968,910 L.L
N06AX16 DEPREVIX HELLAS G Venlafaxine - 150mg 150mg Capsule, prolonged release 968,910 L.L
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