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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
S01AA12 TOBRIN G Tobramycin - 0.3% 0.30% Drops 169,324 L.L
S01AA12 TOBRACIN G Tobramycin - 0.3% 0.30% Ointment 280,863 L.L
S01CA01 CO-AVAZIR G Tobramycin - 0.3%, Dexamethasone - 0.1% Drops suspension 193,513 L.L
L04AC07 ACTEMRA BioTech Tocilizumab - 162mg/0.9ml 162mg/0.9ml Injectable solution 79,959,812 L.L
L04AC07 ACTEMRA BioTech Tocilizumab - 200mg/10ml 200mg/10ml Injectable concentrated solution 25,485,937 L.L
L04AC07 ACTEMRA BioTech Tocilizumab - 400mg/20ml 400mg/20ml Injectable concentrated solution 47,925,322 L.L
L04AC07 ACTEMRA BioTech Tocilizumab - 80mg/4ml 80mg/4ml Injectable concentrated solution 11,127,864 L.L
L04AA29 TRIJAN G Tofacitinib - 10mg 10mg Tablet, film coated 84,793,962 L.L
L04AA29 XELJANZ XR B Tofacitinib - 11mg 11mg Tablet, extended release 78,687,316 L.L
L04AA29 XELJANZ B Tofacitinib - 5mg 5mg Tablet 80,685,473 L.L
L04AA29 TOLVAR G Tofacitinib - 5mg 5mg Tablet, film coated 48,411,736 L.L
L04AA29 TRIJAN G Tofacitinib - 5mg 5mg Tablet, film coated 54,863,315 L.L
L04AA29 XELJANZ B Tofacitinib - 5mg 5mg Tablet L.L
M03BX04 MYDOCALM B Tolperisone - 150mg 150mg Tablet, film coated 839,902 L.L
M03BX04 STIFFANO G Tolperisone - 150mg 150mg Tablet 651,764 L.L
G04BD07 DETRUSITOL B Tolterodine (tartrate) - 2mg 2mg Tablet, film coated 1,995,606 L.L
G04BD07 TOREDA G Tolterodine (tartrate) - 2mg 2mg Tablet, film coated 2,311,409 L.L
N03AX11 TOPAMAX B Topiramate - 100mg 100mg Tablet, film coated 3,471,145 L.L
N03AX11 TOPIRAMATE ARROW G Topiramate - 100mg 100mg Tablet, film coated 1,440,599 L.L
N03AX11 TOPIRATE 100 BENTA G Topiramate - 100mg 100mg Tablet, film coated 2,559,700 L.L
N03AX11 TOPIRAMATE ARROW G Topiramate - 200mg 200mg Tablet, film coated 1,440,599 L.L
N03AX11 TOPIRATE 200 BENTA G Topiramate - 200mg 200mg Tablet, film coated 7,039,175 L.L
N03AX11 TOPAMAX 25 B Topiramate - 25mg 25mg Tablet, film coated 858,715 L.L
N03AX11 TOPIRATE 25 BENTA G Topiramate - 25mg 25mg Tablet, film coated 671,921 L.L
N03AX11 TORAMAT G Topiramate - 25mg 25mg Tablet, film coated 522,755 L.L
N03AX11 TOPAMAX B Topiramate - 50mg 50mg Tablet, film coated 1,914,976 L.L
N03AX11 TOPIRAMATE ARROW G Topiramate - 50mg 50mg Tablet, film coated 765,990 L.L
N03AX11 TOPIRATE 50 BENTA G Topiramate - 50mg 50mg Tablet, film coated 1,407,835 L.L
N03AX11 TORAMAT G Topiramate - 50mg 50mg Tablet, film coated 1,032,071 L.L
L01CE01 HYCAMTIN IV B Topotecan HCl - 4mg 4mg Injectable lyophilised powder for solution 52,580,031 L.L
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