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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
S01ED51 TRAVOPROST/TIMOLOL BIOGARAN G Travoprost - 40mcg/ml, Timolol - 5mg/ml Drops solution 849,308 L.L
L01FD01 TRAZIMERA BioTech Trastuzumab - 440mg 440mg Injectable powder for solution+solvent 75,295,202 L.L
L01FD01 TRAZIMERA BioTech Trastuzumab - 150mg 150mg Injectable powder for solution 28,550,630 L.L
R05CB01 TREBON N G Acetylcysteine - 600mg 600mg Granules for suspension 596,666 L.L
L04AC16 TREMFYA BioTech Guselkumab - 100mg/ml 100mg/ml Injectable solution 190,195,151 L.L
L04AC16 TREMFYA BioTech Guselkumab - 100mg/ml 100mg/ml Injectable solution 190,195,151 L.L
L04AC16 TREMFYA BioTech Guselkumab - 100mg/ml 100mg/ml Injectable solution L.L
N03AX18 TREPADIO G Lacosamide - 200mg/20ml 200mg/20ml Injectable solution 9,569,390 L.L
A10AE06 TRESIBA BioTech Insulin degludec - 100IU/ml 100IU/ml Injectable solution 6,857,628 L.L
D10AD01 TRETINOIN G Tretinoin - 0.05% 0.05% Solution 623,287 L.L
D10AD01 TRETINOIN G Tretinoin - 0.025% 0.025% Solution 564,414 L.L
D10AD01 TRETINOIN G Tretinoin - 0.1% 0.1% Solution 682,160 L.L
N05AX13 TREVICTA B Paliperidone - 175mg 175mg Injectable suspension, prolonged release 35,006,953 L.L
N05AX13 TREVICTA B Paliperidone - 263mg 263mg Injectable suspension, prolonged release 40,713,332 L.L
N05AX13 TREVICTA B Paliperidone - 350mg 350mg Injectable suspension, prolonged release 50,113,800 L.L
N05AX13 TREVICTA B Paliperidone - 525mg 525mg Injectable suspension, prolonged release 75,169,378 L.L
H02AB08 TRIACORT G Triamcinolone acetonide - 40mg/ml 40mg/ml Injectable suspension 745,833 L.L
J01DD04 TRIAXONE G Ceftriaxone (sodium) - 500mg 500mg Injectable powder for solution+diluent 356,118 L.L
J01DD04 TRIAXONE G Ceftriaxone (sodium) - 1g 1g Injectable powder for solution 438,093 L.L
J01DD04 TRIAXONE G Ceftriaxone (sodium) - 1g 1g Injectable powder for solution 4,542,188 L.L
L04AA29 TRIJAN G Tofacitinib - 5mg 5mg Tablet, film coated 54,863,315 L.L
L04AA29 TRIJAN G Tofacitinib - 10mg 10mg Tablet, film coated 84,793,962 L.L
A11DB TRILAGAVIT G Vitamin B12 - 1mg, Vitamin B6 - 100mg, Vitamin B1 - 200mg Tablet, film coated 399,121 L.L
A11DB TRILAGAVIT G Vitamin B12 - 1mg/3ml, Vitamin B6 - 100mg/3ml, Vitamin B1 - 100mg/3ml Injectable solution 579,196 L.L
S01GA52 TRILLERG G Antazoline HCl - 0.5mg, Tetryzoline HCl - 0.4mg Drops solution 310,428 L.L
C09AA05 TRILTEC G Ramipril - 1.25mg 1.25mg Capsule 524,739 L.L
C09AA05 TRILTEC G Ramipril - 2.5mg 2.5mg Capsule 255,970 L.L
C09AA05 TRILTEC G Ramipril - 5mg 5mg Capsule 447,948 L.L
C09AA05 TRILTEC G Ramipril - 10mg 10mg Capsule 575,933 L.L
C09BA05 TRILTEC PLUS G Ramipril - 10mg, Hydrochlorothiazide - 12.5mg Tablet 2,243,577 L.L
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