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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
J01CR02 JULMENTIN ES G Amoxicillin (trihydrate) - 600mg/5ml, Clavulanic Acid (potassium) - 42.9mg/5ml 642.9mg/5ml Powder for suspension 507,972 L.L
N07BC01 BUVIDAL B Buprenorphine - 64mg 64mg Injectable solution prolonged release 34,835,645 L.L
N02BE01 PARANOR G Paracetamol - 650mg 650mg Tablet 162,605 L.L
V03AE07 PHOSPHOLOW G Calcium acetate - 660mg 660mg Tablet 1,118,077 L.L
N02BE01 PANADOL JOINT B Paracetamol - 665mg 665mg Tablet, film coated, prolonged release 291,614 L.L
N02BE01 FEBRADOL JOINT G Paracetamol - 665mg 665mg Tablet 289,246 L.L
G03GA05 GONAL-f BioHuman Follitropin alfa - 900IU/1.5ml 66mcg/1.5ml Injectable solution 29,625,401 L.L
M01AE01 NEURALGINE EXTRA IBU-LYSINAT B Ibuprofen (DL Lysine) - 400mg (684mg) 684mg Tablet, film coated 833,182 L.L
G03AC08 IMPLANON NXT B Etonogestrel - 68mg 68mg Implant 12,299,971 L.L
L03AA13 ZIEXTENZO BioTech Pegfilgrastim - 6mg 6mg Injectable solution L.L
N05AX13 INVEGA B Paliperidone - 6mg 6mg Tablet, prolonged release 5,825,557 L.L
N05AX15 REAGILA G Cariprazine - 6mg 6mg Capsule, hard 6,394,003 L.L
J07AX URO-VAXOM B Lyophilized bacterial lysates of E-Coli - 6mg 6mg Capsule 2,689,029 L.L
N05BA08 BROMAZEPAM BIOGARAN G Bromazepam - 6mg 6mg Tablet, scored 180,075 L.L
P02CF01 IVER G Ivermectin - 6mg 6mg Tablet 431,373 L.L
L03AA13 ZIEXTENZO BioTech Pegfilgrastim - 6mg 6mg Injectable solution 42,676,168 L.L
P02CF01 IVERMECTIN BENTA G Ivermectin - 6mg 6mg Tablet 784,548 L.L
L03AA13 FULPHILA G Pegfilgrastim - 6mg 6mg Injectable solution 30,257,174 L.L
P02CF01 IVERMECTIN BENTA G Ivermectin - 6mg 6mg Tablet 470,985 L.L
N03AX22 FYCOMPA B Perampanel - 6mg 6mg Tablet, film coated 8,751,127 L.L
A10BB12 JOSWE GLEMAX 6 G Glimepiride - 6mg 6mg Caplet 663,858 L.L
H02AB13 DEFAL B Deflazacort - 6mg 6mg Tablet 415,247 L.L
S01LA09 VABYSMO B Faricimab - 6mg/0.05ml 6mg/0.05ml Injectable solution L.L
S01LA09 VABYSMO B Faricimab - 6mg/0.05ml 6mg/0.05ml Injectable solution 54,991,170 L.L
L03AA13 NEULASTIM BioTech Pegfilgrastim - 6mg/0.6ml 6mg/0.6ml Injectable solution 56,925,965 L.L
N04BC09 NEUPRO B Rotigotine - 6mg/24h 6mg/24h Patch 9,427,593 L.L
C01EB10 CARDESINE G Adenosine - 6mg/2ml 6mg/2ml Injectable solution 563,070 L.L
M05BA06 BONDRONAT B Ibandronic acid (monosodium monohydrate) - 6mg/6ml 6mg/6ml Injectable concentrated powder for solution 24,963,868 L.L
A10BJ02 SAXENDA BioTech Liraglutide - 6mg/ml 6mg/ml Injectable solution 16,747,035 L.L
R06AX29 LABIXTEN B Bilastine - 6mg/ml 6mg/ml Drops solution 1,647,551 L.L
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