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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
J05AF07 TENVOR G Tenofovir disoproxil fumarate - 300mg 300mg Tablet, film coated 3,753,352 L.L
L01CE02 IRNOCAM 100 G Irinotecan HCl - 100mg/5ml 100mg/5ml Injectable solution 7,320,947 L.L
L01XG01 VELZOME G Bortezomib - 3.5mg 3.5mg Injectable powder for solution 18,154,041 L.L
L04AX04 LENALIDOMIDE NEAPOLIS G Lenalidomide - 25mg 25mg Capsule 76,719,234 L.L
N02CC01 SUMAREX G Sumatriptan (succinate) - 100mg 100mg Tablet, film coated 1,088,512 L.L
N05AX12 ABIPREX 10 G Aripiprazole - 10mg 10mg Tablet 1,075,074 L.L
N07CA01 VERTINEX G Betahistine dihydrochloride - 16mg 16mg Tablet, scored 1,204,339 L.L
R05CB03 MUCOTAL ADULTE G Carbocysteine - 250mg/5ml 250mg/5ml Syrup 308,444 L.L
S01XA20 LUBRI-TEARS G Carmellose sodium - 2mg Drops solution 792,867 L.L
B05BB02 DEXTROSE 5% & SODIUM CHLORIDE 0.3% G Sodium chloride - 0.3g/100ml, Dextrose, H2O - 5g/100ml Injectable solution 220,643 L.L
C09AA05 APO-RAMIPRIL G Ramipril - 2.5mg 2.5mg Capsule 463,626 L.L
C10AA01 SIMVASTATIN NORMON G Simvastatin - 40mg 40mg Tablet, film coated 264,737 L.L
D06BA02 CREM-O-SULFA G Sulfathiazole - 5% 5% Cream 202,216 L.L
J01AA12 TEGADIS G Tigecycline - 50mg 50mg Injectable powder for solution 2,418,917 L.L
J01DH51 IMIPENEM-CILASTATIN LABATEC G Imipenem (monohydrate) - 500mg, Cilastatin (sodium) - 500mg Injectable powder for solution 8,922,845 L.L
J05AF10 AVIRAVIR G Entecavir monohydrate - 1mg 1mg Tablet, film coated 32,224,230 L.L
L01CE02 IRINOTECAN THYMOORGAN G Irinotecan HCl - 40mg/2ml 40mg/2ml Injectable concentrated solution 2,123,271 L.L
L04AX04 LENALIDOMIDE SPC G Lenalidomide - 25mg 25mg Capsule, hard 87,161,381 L.L
M05BA06 ADROMUX G Ibandronic acid - 150mg 150mg Tablet, coated 821,088 L.L
N05AX12 ATYPRAL G Aripiprazole - 10mg 10mg Tablet 712,237 L.L
N07CA01 VERTINEX G Betahistine dihydrochloride - 16mg 16mg Tablet 371,157 L.L
R05CB06 API-MUCOL G Ambroxol HCl - 15mg/5ml 15mg/5ml Syrup 326,554 L.L
S02AA15 CETRAXAL OTICO G Ciprofloxacine (HCl) - 3mg/ml 3mg/ml Drops 821,088 L.L
B05BC01 MANNITOL G Mannitol - 20g/100ml 20g/100ml Injectable solution 406,810 L.L
C01EB10 CARDESINE G Adenosine - 6mg/2ml 6mg/2ml Injectable solution 563,070 L.L
C09AA05 NORMOPRIL G Ramipril - 2.5mg 2.5mg Tablet 229,797 L.L
C10AA01 SIMVASTATIN-REMEDICA G Simvastatin - 40mg 40mg Tablet, film coated 780,772 L.L
D06BA05 NEO SULFA G Sulfanilamide - 12g 12g Powder 151,022 L.L
J01AA12 TIGECYCLINE /ANFARM G Tigecycline - 50mg 50mg Injectable powder for solution 15,214,166 L.L
J01DH51 IMIPENEME CILASTATINE PANPHARMA G Imipenem (monohydrate) - 500mg, Cilastatin (sodium) - 500mg Injectable powder for solution 9,421,088 L.L
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