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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
J01MA06 NOROXIN B Norfloxacin - 400mg 400mg Tablet, film-scored 574,653 L.L
N06AB05 PAXERA G Paroxetine (HCl) - 20mg 20mg Tablet, film-scored 1,016,841 L.L
J01MA12 TAVANIC B Levofloxacin - 500mg 500mg Tablet, film-scored 1,150,329 L.L
N06AB08 FAVERIN B Fluvoxamine maleate - 100mg 100mg Tablet, film-scored 1,291,433 L.L
A10BD02 GLYSTOR PLUS G Metformin HCl - 500mg, Glibenclamide - 2.5mg Tablet, film-scored 533,697 L.L
A10BD02 GLYSTOR PLUS G Metformin HCl - 500mg, Glibenclamide - 5mg Tablet, film-scored 691,119 L.L
C08CA13 LERCADIP B Lercanidipine HCl - 10mg 10mg Tablet, film-scored 1,021,320 L.L
C08CA13 LERCADIP B Lercanidipine HCl - 20mg 20mg Tablet, film-scored 1,679,803 L.L
N05AL05 SOLIAN B Amisulpride - 400mg 400mg Tablet, film-scored 1,764,465 L.L
M04AA03 ADENURIC B Febuxostat - 80mg 80mg Tablet, film-scored 2,127,111 L.L
J01AA02 GRANUDOXY G Doxycycline (monohydrate) - 100mg 100mg Tablet, film-scored 318,491 L.L
J01AA02 GRANUDOXY G Doxycycline (monohydrate) - 100mg 100mg Tablet, film-scored 282,207 L.L
L01EB01 IRESSA B Gefitinib - 250mg 250mg Tablet, fim coated 135,027,509 L.L
M01AB05 OLFEN-50 G Diclofenac sodium - 50mg 50mg Tablet, gastroresistant 248,611 L.L
A07EC02 SALCROZINE G Mesalazine - 500mg 500mg Tablet, gastroresistant 2,013,076 L.L
A07EC02 SALCROZINE G Mesalazine - 1g 1g Tablet, gastroresistant 4,073,187 L.L
A02BC02 PANTO TAD G Pantoprazole (sodium) - 40mg 40mg Tablet, gastroresistant 470,345 L.L
A02BC02 PANTO TAD G Pantoprazole (sodium) - 20mg 20mg Tablet, gastroresistant 294,302 L.L
A02BC04 PARIET B Rabeprazole (sodium) - 20mg 20mg Tablet, gastroresistant 779,429 L.L
A02BC04 PULOROS 28 G Rabeprazole sodium - 20mg 20mg Tablet, gastroresistant 706,861 L.L
A02BC04 RAMEP G Rabeprazole (sodium) - 20mg 20mg Tablet, gastroresistant 518,809 L.L
A02BC05 NEXIUM B Esomeprazole (magnesium trihydrate) - 20mg 20mg Tablet, gastroresistant 1,005,194 L.L
A02BC05 NEXIUM B Esomeprazole (magnesium trihydrate) - 20mg 20mg Tablet, gastroresistant 1,005,194 L.L
A02BC05 ESOMEP G Esomeprazole - 20mg 20mg Tablet, gastroresistant 432,092 L.L
L04AA06 MYFORTIC B Mycophenolic acid (sodium) - 360mg 360mg Tablet, gastroresistant 20,324,991 L.L
A02BC05 ESOMEP G Esomeprazole - 40mg 40mg Tablet, gastroresistant 493,392 L.L
A02BC05 METAPRO G Esomeprazole - 40mg 40mg Tablet, gastroresistant 639,669 L.L
A16AX BICANORM G Sodium bicarbonate - 1000mg 1000mg Tablet, gastroresistant 2,623,181 L.L
J02AC04 NOXAFIL B Posaconazole - 100mg 100mg Tablet, gastroresistant 62,027,714 L.L
L04AA06 MYFORTIC B Mycophenolic acid (sodium) - 360mg 360mg Tablet, gastroresistant L.L
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