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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
A03AX HEPABYL G Sorbitol - 2.5g/5ml, Diisopromine - 0.02g/5ml Liquid 238,052 L.L
C09DA04 CO APROVEL B Irbesartan - 300mg, Hydrochlorothiazide - 12.5mg Tablet, film coated 658,483 L.L
C10BA05 ATOZET B Atorvastatin - 20mg, Ezetimibe - 10mg Tablet, film coated 2,046,672 L.L
R03AL02 IPRASAL VEM G Salbutamol (sulfate) - 2.5mg/2.5ml, Ipratropium bromide (monohydrate) - 0.5mg/2.5ml Inhaltion solution with nebuliser 417,935 L.L
A03AX SPASMO-DIGESTIN B Simethicone - 30mg, Dicyclomine HCl - 5mg, Sodium dihydrocholate - 10mg, Sanzyme 3500 - 36mg, Papain - 100mg Tablet, enteric coated 260,705 L.L
C09DA04 ANDARAN PLUS G Irbesartan - 300mg, Hydrochlorothiazide - 12.5mg Tablet, film coated 598,051 L.L
C10BA05 ATOZET B Atorvastatin - 20mg, Ezetimibe - 10mg Tablet, film coated 2,046,672 L.L
R03AL03 ANORO ELLIPTA B Vilanterol - 25mcg, Umeclidinium bromide - 62.5mcg Inhalation powder 5,367,774 L.L
A03AX12 SPASFON B Phloroglucinol hydrate - 80mg, Trimethylphloroglucinol - 80mg Tablet, coated 278,175 L.L
A12AX DECALCIT B Vitamin D3 - 500IU, Calcium - 600mg Tablet 912,469 L.L
C09DA04 CONVERIUM PLUS G Irbesartan - 300mg, Hydrochlorothiazide - 12.5mg Tablet, film coated 395,090 L.L
C10BA05 LIPONORM PLUS 20/10 G Atorvastatin - 20mg, Ezetimibe - 10mg Tablet 1,226,928 L.L
D11AX18 LABDIC RELIEF G Diclofenac sodium - 1%w/w, Methyl salicylate - 8%w/w, Menthol - 2%w/w Gel 263,393 L.L
R03AL04 ULTIBRO BREEZHALER B Indacaterol - 110mcg, Glycopyronium - 50mcg Capsule, inhalation 4,031,528 L.L
A03AX12 PHLOROGLUCINOL/TRIMETHYLPHLOROGLUCINOL ARROW G Phloroglucinol - 40mg/4ml, Trimethylphloroglucinol - 0.04mg/4ml Injectable solution 940,690 L.L
A12AX DECALCIT B Vitamin D3 - 500IU, Calcium - 600mg Tablet 348,055 L.L
C09DA04 GIZLAN-PLUS G Irbesartan - 300mg, Hydrochlorothiazide - 12.5mg Tablet, film coated 395,090 L.L
C10BA05 OTOREZA 10MG/20MG G Atorvastatin - 20mg, Ezetimibe - 10mg Tablet, film coated 858,715 L.L
L01BA04 PEMETREXED NEAPOLIS G Pemetrexed (disodium) - 500mg Injectable powder 41,289,202 L.L
R03AL06 SPIOLTO RESPIMAT B Olodaterol HCl - 2.5mcg/puff, Tiotropium bromide monohydrate - 2.5mcg/puff Inhalation solution 5,087,788 L.L
A12AX OSTRONG G Vitamin D3 - 500IU, Calcium hydrogen phosphate - 600mg Tablet 435,149 L.L
B05AA01 ALBUTEIN BioHuman Albumin human - 20% Injectable solution 4,031,528 L.L
C09DA04 IBECARD PLUS 300/12.5 G Irbesartan - 300mg, Hydrochlorothiazide - 12.5mg Tablet, film coated 559,294 L.L
C10BA05 ATOZET B Atorvastatin - 40mg, Ezetimibe - 10mg Tablet, film coated 2,046,672 L.L
R03AL11 BREZTRI AEROSPHERE B Formoterol fumarate dihydrate - 5mcg, Glycopyrronium Bromide - 7.2mcg, Budesonide - 160mcg Inhalation suspension 6,705,774 L.L
A12AX DECALCIT B Vitamin D3 - 750IU, Calcium - 600mg Powder 1,075,074 L.L
C09DA04 IRBAVEL PLUS 300/12.5 G Irbesartan - 300mg, Hydrochlorothiazide - 12.5mg Tablet, film coated 559,294 L.L
C10BA05 ATOZET B Atorvastatin - 40mg, Ezetimibe - 10mg Tablet, film coated 2,046,672 L.L
A03AX13 MOSAR PLUS B Mosapride citrate - 5mg, Simethicone - 200mg Tablet, coated 865,435 L.L
A12AX CALPEROS D3 A SUCER B Vitamin D3 - 400IU, Calcium - 500mg Tablet, chewable 667,890 L.L
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