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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
M01AH05 ETOXA G Etoricoxib - 60mg 60mg Tablet, film coated 1,109,630 L.L
M01AH05 ETOXA G Etoricoxib - 60mg 60mg Tablet, film coated 369,877 L.L
M01AH05 ETOXIB G Etoricoxib - 60mg 60mg Tablet, film coated 1,217,521 L.L
N06AX21 DULOXA 60 G Duloxetine HCl - 60mg 60mg Capsule, delayed release 831,903 L.L
N06AX21 LOXYT 60 G Duloxetine HCl - 60mg 60mg Capsule, delayed release 831,903 L.L
N06AX21 PMS-DULOXETINE G Duloxetine HCl - 60mg 60mg Capsule, delayed release 976,973 L.L
L01XG02 KYPROLIS B Carfilzomib - 60mg 60mg Injectable powder for solution L.L
N06AX21 DULOXETINE BIOGARAN G Duloxetine HCl - 60mg 60mg Capsule, gastro-resistant 573,821 L.L
N06BA09 APO-ATOMOXETINE G Atomoxetine (HCl) - 60mg 60mg Capsule 4,731,669 L.L
N06BA09 PMS-ATOMOXETINE G Atomoxetine (HCl) - 60mg 60mg Capsule 5,228,891 L.L
A10BB09 DIAMICRON MR B Gliclazide - 60mg 60mg Tablet, modified release 382,995 L.L
A10BB09 LOWZID XR G Gliclazide - 60mg 60mg Tablet, extended release 309,724 L.L
M02AA31 ROXONIN B Loxoprofen (Sodium) - 60mg 60mg Tablet 788,836 L.L
M02AA31 ROXONIN B Loxoprofen (Sodium) - 60mg 60mg Tablet 1,295,464 L.L
C08CA05 NIFELAT 60 LA G Nifedipine - 60mg 60mg Tablet, prolonged release 1,290,089 L.L
C08DB01 APO-DILTIAZ G Diltiazem HCl - 60mg 60mg Tablet 545,600 L.L
C08DB01 ZALDEM G Diltiazem HCl - 60mg 60mg Tablet, scored 199,657 L.L
N07AA02 MESTINON B Pyridostigmine bromide - 60mg 60mg Tablet, sugar coated 3,090,838 L.L
H05BX01 CINACALCET ARROW BioTech Cinacalcet - 60mg 60mg Tablet, coated, scored 16,494,074 L.L
B01AC24 KLOTEGO G Ticagrelor - 60mg 60mg Tablet, film coated 2,598,096 L.L
B01AC24 KLOTEGO G Ticagrelor - 60mg 60mg Tablet, film coated 2,598,096 L.L
L01XG02 KYPROLIS B Carfilzomib - 60mg 60mg Injectable powder for solution 96,642,005 L.L
B02BX06 HEMLIBRA BioTech Emicizumab - 60mg/0.4ml 60mg/0.4ml Injectable solution 441,042,377 L.L
B02BX06 HEMLIBRA BioTech Emicizumab - 60mg/0.4ml 60mg/0.4ml Injectable solution L.L
L01CD04 JEVTANA INJECTION B Cabazitaxel - 60mg/1.5ml 60mg/1.5ml Injectable dry powder for solution+diluent 75,619,931 L.L
L01CD04 JEVTANA INJECTION B Cabazitaxel - 60mg/1.5ml 60mg/1.5ml Injectable dry powder for solution+diluent 75,619,931 L.L
M05BX04 PROLIA BioTech Denosumab - 60mg/ml 60mg/ml Injectable solution 21,603,638 L.L
N07XX08 VYNDAMAX B Tafamidis - 61mg 61mg Capsule 784,020,041 L.L
C02KX01 TRACLEER B Bosentan (monohydrate) - 62.5mg 62.5mg Tablet, film coated 79,583,961 L.L
C02KX01 TRACLEER B Bosentan (monohydrate) - 62.5mg 62.5mg Tablet, film coated 79,583,961 L.L
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