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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
L01XK04 TALZENNA B Talazoparib - 0.25mg 0.25mg Capsule 133,836,699 L.L
R05CB06 MUCOSOLVAN LA B Ambroxol HCl - 75mg 75mg Capsule 345,368 L.L
J01CA01 ANTALPEN G Ampicillin (trihydrate) - 500mg 500mg Capsule 285,407 L.L
R05CB06 SOLVAMUC SR G Ambroxol - 75mg 75mg Capsule 276,448 L.L
M01AB01 INDOMEL G Indometacin - 25mg 25mg Capsule 170,220 L.L
C09AA05 APO-RAMIPRIL G Ramipril - 10mg 10mg Capsule 1,178,550 L.L
J01CA04 AMOXICILLIN G Amoxicillin (trihydrate) - 500mg 500mg Capsule 6,199,145 L.L
N03AB02 EPANUTIN B Phenytoin sodium - 100mg 100mg Capsule 739,113 L.L
J01CA04 AMOXICILLINE ARROW LAB G Amoxicillin (trihydrate) - 500mg 500mg Capsule 564,414 L.L
L01XX05 CUREAML G Hydroxycarbamide (or Hydroxyurea) - 500mg 500mg Capsule 1,228,272 L.L
N03AB02 EPANUTIN B Phenytoin sodium - 100mg 100mg Capsule 739,113 L.L
N07XX08 VYNDAMAX B Tafamidis - 61mg 61mg Capsule 784,020,041 L.L
C09AA05 TRILTEC G Ramipril - 10mg 10mg Capsule 575,933 L.L
J01CA04 AMOXIDREX G Amoxicillin (trihydrate) - 500mg 500mg Capsule 254,690 L.L
L01XX05 CYTODROX G Hydroxycarbamide (or Hydroxyurea) - 500mg 500mg Capsule 3,301,821 L.L
J01CA04 AMOXIDREX G Amoxicillin (trihydrate) - 500mg 500mg Capsule 7,332,097 L.L
J05AH02 TAMIFLU B Oseltamivir (phosphate) - 75mg 75mg Capsule 1,464,788 L.L
C10AA05 JOSWE ATORVAST 10 G Atorvastatin - 10mg 10mg Caplet, film coated 849,308 L.L
C10AA05 JOSWE ATORVAST 20 G Atorvastatin - 20mg 20mg Caplet, film coated 956,816 L.L
C10AA05 JOSWE ATORVAST 40 G Atorvastatin - 40mg 40mg Caplet, film coated 1,327,716 L.L
M01AE51 PROFINAL XP G Ibuprofen - 400mg, Caffeine - 65mg Caplet, film coated 286,238 L.L
C10BX03 JOSWE DUBARA 5/10 G Amlodipine - 5mg, Atorvastatin - 10mg Caplet, film coated 2,370,538 L.L
C10BX03 JOSWE DUBARA 10/10 G Amlodipine - 10mg, Atorvastatin - 10mg Caplet, film coated 2,655,433 L.L
N05AH03 PREXAL 5 G Olanzapine - 5mg 5mg Caplet, film coated 718,956 L.L
C09DB01 ARBITEN AM 5/160 G Amlodipine - 5mg, Valsartan - 160mg Caplet, film coated 857,372 L.L
C09DB01 ARBITEN AM 10/160 G Amlodipine - 10mg, Valsartan - 160mg Caplet, film coated 857,372 L.L
N05AH03 PREXAL 10 G Olanzapine - 10mg 10mg Caplet, film coated 881,561 L.L
N05AX08 RESPAL 1 G Risperidone - 1mg 1mg Caplet, film coated 309,084 L.L
N05AX08 RESPAL 2 G Risperidone - 2mg 2mg Caplet, film coated 342,680 L.L
N05AX08 RESPAL 4 G Risperidone - 4mg 4mg Caplet, film coated 557,695 L.L
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