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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
A10BA02 DIAPHAGE G Metformin HCl - 500mg 500mg Tablet, film coated 119,602 L.L
A10AE56 XULTOPHY BioTech Insulin degludec - 100U/ml, Liraglutide - 3.6mg/ml Injectable solution 13,503,847 L.L
A10AE56 XULTOPHY BioTech Insulin degludec - 100U/ml, Liraglutide - 3.6mg/ml Injectable solution 13,503,847 L.L
A10AE54 SULIQUA BioTech Insulin glargine - 100IU/ml, Lixisenatide - 33mcg/ml Injectable solution 7,975,793 L.L
A10AE54 SULIQUA BioTech Insulin glargine - 100IU/ml, Lixisenatide - 50mcg/ml Injectable solution 11,286,573 L.L
A10AE06 TRESIBA BioTech Insulin degludec - 100IU/ml 100IU/ml Injectable solution 6,857,628 L.L
A10AE04 TOUJEO BioTech Insulin glargine - 300Units/ml 300Units/ml Injectable solution 4,559,658 L.L
A10AE04 LANTUS BioTech Insulin glargine - 100IU/ml 100IU/ml Injectable solution 3,327,354 L.L
A10AE04 LANTUS SOLOSTAR BioTech Insulin glargine - 100IU/ml 100IU/ml Injectable solution 4,992,375 L.L
A10AE04 GLARTUS BioTech Insulin glargine - 100U/ml 100U/ml Injectable solution 1,346,530 L.L
A10AE04 BASAGLAR KWIKPEN BioTech Insulin glargine - 100U/ml 100U/ml Injectable solution 4,114,846 L.L
A10AE01 JUSLINE N BioTech Insulin human isophane - 100IU/ml 100IU/ml Injectable suspension 401,809 L.L
A10AE01 INSULATARD BioTech Insulin (human) - 100IU/ml 100IU/ml Injectable suspension 752,552 L.L
A10AE01 INSULATARD BioTech Insulin (human) - 100IU/ml 100IU/ml Injectable suspension 752,552 L.L
A10AE01 HUMULIN N U-100 BioTech Insulin (human) - 100IU/ml 100IU/ml Injectable suspension 701,486 L.L
A10AD06 RYZODEG BioTech Insulin degludec - 70%, Insulin aspart - 30% 100IU/ml Injectable solution 7,058,661 L.L
A10AD05 NOVOMIX 30 BioTech Insulin aspart - 30%, Insulin aspart protamine - 70% 100IU/ml Injectable suspension 4,264,012 L.L
A10AD05 NOVOMIX 30 BioTech Insulin aspart - 30%, Insulin aspart protamine - 70% 100IU/ml Injectable suspension 4,264,012 L.L
A10AD05 NOVOMIX 30 BioTech Insulin aspart - 30%, Insulin aspart protamine - 70% 100IU/ml Injectable suspension 4,264,012 L.L
A10AD04 HUMALOG MIX 25 KWIKPEN BioTech Insulin lispro solution - 25%, Insulin lispro protamine suspension - 75% 100IU/ml Injectable suspension 3,950,897 L.L
A10AD04 HUMALOG MIX 50 KWIKPEN BioTech Insulin lispro solution - 50%, Insulin lispro protamine suspension - 50% 100IU/ml Injectable suspension 3,950,897 L.L
A10AD01 MIXTARD 30 BioTech Insulin (human) - 100IU/ml 100IU/ml Injectable suspension 752,552 L.L
A10AD01 MIXTARD 30 BioTech Insulin (human) - 100IU/ml 100IU/ml Injectable suspension 752,552 L.L
A10AD01 JUSLINE BioTech Insulin (human) - 100IU/ml 100IU/ml Injectable suspension 401,809 L.L
A10AD01 HUMULIN 70/30 BioTech Insulin (human) - 100IU/ml 100IU/ml Injectable suspension 701,486 L.L
A10AB06 APIDRA BioTech Insulin glulisine - 100IU/ml 100IU/ml Injectable solution 2,221,372 L.L
A10AB06 APIDRA SOLOSTAR BioTech Insulin glulisine - 100IU/ml 100IU/ml Injectable solution 3,942,834 L.L
A10AB05 NOVORAPID FLEXPEN BioTech Insulin aspart - 100IU/ml 100IU/ml Injectable solution 3,123,090 L.L
A10AB05 NOVORAPID FLEXPEN BioTech Insulin aspart - 100IU/ml 100IU/ml Injectable solution 3,123,090 L.L
A10AB05 NOVORAPID FLEXPEN BioTech Insulin aspart - 100IU/ml 100IU/ml Injectable solution 3,123,090 L.L
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