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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
A10BD08 VILDIAB M 50/850 G Metformin HCl - 850mg, Vildagliptin - 50mg Tablet, film coated 1,029,383 L.L
B01AC24 KLOTEGO G Ticagrelor - 60mg 60mg Tablet, film coated 2,598,096 L.L
B05BB02 HI-SODIUM INJECTION WITH POTASSIUM G Potassium chloride - 0.149g/100ml, Sodium dihydrogenophosphate - 0.137g/100ml, Sodium lactate (anhydre) - 0.223g/100ml, Sodium chloride - 0.175g/100ml, Dextrose monohydrate - 5g/100ml Injectable solution 165,727 L.L
C09AA03 TENSIKEY G Lisinopril - 5mg 5mg Tablet 456,906 L.L
C10AA01 STAVINE G Simvastatin - 10mg 10mg Tablet 207,336 L.L
D06AX01 ZETA G Fusidic acid - 20mg/g 20mg/g Cream 178,731 L.L
J01DH02 MIRAN G Meropenem (trihydrate) - 1g 1g Injectable powder for solution 819,744 L.L
J05AF01 REVODINE G Zidovudine - 300mg 300mg Tablet, film coated 7,771,552 L.L
L01XG01 ALVOCADE G Bortezomib - 3.5mg 3.5mg Injectable powder for solution 14,169,600 L.L
L04AX04 LENALIDOMIDE ARROW G Lenalidomide - 15mg 15mg Capsule 26,651,802 L.L
M04AC01 COLCHICINE SEID G Colchicine - 1mg 1mg Tablet 382,995 L.L
N02BF02 NEUREXAL G Pregabalin - 25mg 25mg Capsule 321,754 L.L
N05AX08 DEPIA G Risperidone - 4mg 4mg Tablet, scored 499,142 L.L
R05CA12 HEDECTON COUGH G Ivy leaf soft extract - 40mg/5ml Syrup 467,657 L.L
A04AA02 GRANI-DENK G Granisetron - 1mg/ml 1mg/ml Injectable concentrate for solution 893,655 L.L
A10BD08 VLUDIN MET G Metformin HCl - 850mg, Vildagliptin - 50mg Tablet, film coated 735,914 L.L
B01AC24 KLOTEGO G Ticagrelor - 60mg 60mg Tablet, film coated 2,598,096 L.L
B05BB02 LO-SODIUM INJECTION G Sodium lactate - 0.223g/100ml, Sodium dihydrogenophosphate - 0.137g/100ml, Potassium chloride - 0.149g/100ml, Sodium chloride - 0.0585g/100ml, Dextrose, H2O - 5.0g/100ml Injectable solution 179,456 L.L
C01DX12 MOLSIDOMINE BIOGARAN G Molsidomine - 2mg 2mg Tablet, scored 256,674 L.L
C10AA01 VASCOR G Simvastatin - 10mg 10mg Tablet, scored 284,127 L.L
J01AA07 TETRACYCLINE G Tetracycline HCl - 250mg 250mg Capsule 3,906,998 L.L
J01DH02 ROPENEM 1000 BENTA G Meropenem (trihydrate) - 1000mg 1g Injectable powder for solution 995,723 L.L
J05AF05 LAMIVUDINE ARROW G Lamivudine - 150mg 150mg Tablet, coated, scored 7,850,907 L.L
L01XG01 BORCADE G Bortezomib - 3.5mg 3.5mg Injectable lyophilised powder 11,020,381 L.L
L04AX04 LENALIDOMIDE NEAPOLIS G Lenalidomide - 15mg 15mg Capsule 76,209,421 L.L
N02BF02 PLENICA G Pregabalin - 25mg 25mg Capsule 697,454 L.L
N05AX08 PMS-RISPERIDONE G Risperidone - 4mg 4mg Tablet 1,276,650 L.L
N07BC51 SUBOXONE G Buprenorphine HCl - 2mg, Naloxone HCl - 0.5mg Tablet, sublingual 1,473,590 L.L
B05BB02 LO-SODIUM WITH POTASSIUM INJECTION G Potassium chloride - 0.149g/100ml, Sodium dihydrogenophosphate - 0.137g/100ml, Sodium lactate - 0.223g/100ml, Sodium chloride - 0.0585g/100ml, Dextrose monohydrate - 5g/100ml Injectable solution 165,727 L.L
C01DX12 MOLSIDOMINE BIOGARAN G Molsidomine - 2mg 2mg Tablet, scored 713,580 L.L
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