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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
A11DB NEUROMED G Vitamin B12 - 200mcg, Vitamin B6 - 200mg, Vitamin B1 - 100mg Tablet, coated 257,250 L.L
C09DA03 CO-DIOVAN B Valsartan - 160mg, Hydrochlorothiazide - 12.5mg Tablet, film coated 846,621 L.L
N04BA03 COMBIPAR G Levodopa - 50mg, Carbidopa - 12.5mg, Entacapone - 200mg Tablet, film coated 1,103,403 L.L
R03AK06 SEROFLO-S 250 G Salmeterol (xinafoate) - 25mcg/inhalation, Fluticasone propionate - 250mcg/inhalation Inhalation suspension 1,725,494 L.L
A11DB NEURORUBINE-FORTE G Vitamin B12 - 1mg, Vitamin B6 - 50mg, Vitamin B1 - 200mg Tablet, film coated 262,049 L.L
C09DA03 ARBITEN PLUS G Valsartan - 160mg, Hydrochlorothiazide - 12.5mg Tablet 544,256 L.L
R03AK07 SYMBICORT B Formoterol fumarate dihydrate - 4.5mcg/Inhalation, Budesonide - 160mcg/Inhalation Inhalation powder 3,378,420 L.L
A10AE54 SULIQUA BioTech Insulin glargine - 100IU/ml, Lixisenatide - 50mcg/ml Injectable solution 11,286,573 L.L
A11DB TRILAGAVIT G Vitamin B12 - 1mg, Vitamin B6 - 100mg, Vitamin B1 - 200mg Tablet, film coated 399,121 L.L
C09DA03 CO-ANGINET G Valsartan - 160mg, Hydrochlorothiazide - 12.5mg Tablet, film coated 544,256 L.L
R03AK07 SYMBICORT TURBUHALER B Formoterol fumarate dihydrate - 4.5mcg/inhalation, Budesonide - 160mcg/inhalation Inhalation powder 1,689,210 L.L
A02BD08 PYLERA B Bismuth subcitrate potassium - 140mg, Tetracycline HCl - 125mg, Metronidazole - 125mg Capsule 6,156,142 L.L
A10AE54 SULIQUA BioTech Insulin glargine - 100IU/ml, Lixisenatide - 33mcg/ml Injectable solution 7,975,793 L.L
A11DB 3V G Vitamin B12 - 1mg/3ml, Vitamin B6 - 100mg/3ml, Vitamin B1 - 100mg/3ml Injectable solution 198,889 L.L
C09DA03 CO-TABUVAN G Valsartan - 160mg, Hydrochlorothiazide - 12.5mg Tablet, film coated 544,256 L.L
R03AK07 BUFOMIX EASYHALER G Formoterol fumarate dihydrate - 4.5mcg/inhalation, Budesonide - 160mcg/inhalation Metered dose inhaler 2,365,163 L.L
A10AE56 XULTOPHY BioTech Insulin degludec - 100U/ml, Liraglutide - 3.6mg/ml Injectable solution 13,503,847 L.L
A11DB TRILAGAVIT G Vitamin B12 - 1mg/3ml, Vitamin B6 - 100mg/3ml, Vitamin B1 - 100mg/3ml Injectable solution 579,196 L.L
C09DA03 VALUSTAR PLUS G Valsartan - 160mg, Hydrochlorothiazide - 12.5mg Tablet, film coated 592,635 L.L
J01RA MEDSPIRAGYL G Metronidazole - 125mg, Spiramycin - 750,000IU Tablet, scored 474,824 L.L
R03AK07 BUFOMIX EASYHALER G Formoterol fumarate dihydrate - 4.5mcg/inhalation, Budesonide - 160mcg/inhalation Metered dose inhaler 1,182,581 L.L
A02BX13 GAVISCON B Sodium alginate - 500mg/10ml, Sodium bicarbonate - 267mg/10ml, Calcium (carbonate) - 160mg/10ml Liquid 295,645 L.L
A10AE56 XULTOPHY BioTech Insulin degludec - 100U/ml, Liraglutide - 3.6mg/ml Injectable solution 13,503,847 L.L
A11DB VITANOR G Vitamin B1 - 250mg, Vitamin B6 - 250mg, Vitamin B12 - 500mcg Tablet, film coated 946,065 L.L
C09DA03 VIOSTAN PLUS 160/12.5 G Valsartan - 160mg, Hydrochlorothiazide - 12.5mg Tablet, film coated 668,082 L.L
J01RA SPIRAGYL G Metronidazole - 125mg, Spiramycin - 750,000IU Tablet, scored 474,824 L.L
R03AK07 SYMBICORT B Formoterol fumarate dihydrate - 9mcg/Inhalation, Budesonide - 320mcg/Inhalation Inhalation powder 3,378,420 L.L
A02BX13 GAVISCON INFANT B Sodium alginate - 225mg, Magnesium alginate - 87.5mg Powder for suspension 710,893 L.L
A11EA BECOZYME B Vitamin B5 - 6mg/2ml, Vitamin B6 - 4mg/2ml, Vitamin PP - 40mg/2ml, Vitamin B2 - 5.47mg/2ml, Vitamin B1 - 10mg/2ml Injectable solution 662,514 L.L
C09DA03 CO-DIOVAN B Valsartan - 160mg, Hydrochlorothiazide - 25mg Tablet, film coated 901,718 L.L
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