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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
M02AA31 ROXONIN TAPE B Loxoprofen Sodium Hydrate - 50mg 50mg Patch 710,893 L.L
N05AH04 REZAL XR G Quetiapine fumarate - 50mg 50mg Tablet, extended release 533,505 L.L
N07XX02 RILUTEK B Riluzole - 50mg 50mg Tablet, film coated 15,886,212 L.L
N07XX02 RILUTEK B Riluzole - 50mg 50mg Tablet, film coated 15,886,212 L.L
N07XX02 RILUTEK B Riluzole - 50mg 50mg Tablet, film coated 15,886,212 L.L
R01AD08 RINISONA G Fluticasone propionate - 50mcg/actuation 50mcg/dose Spray, suspension 556,351 L.L
L01FA01 RITUXIREL BioTech Rituximab - 500mg/50ml 500mg/50ml Injectable concentrated solution L.L
L01FA01 RITUXIREL BioTech Rituximab - 500mg/50ml 500mg/50ml Injectable concentrated solution 45,258,360 L.L
L01FA01 RIXATHON BioTech Rituximab - 500mg/50ml 500mg/50ml Injectable concentrate for solution 66,951,899 L.L
L01FA01 RIXATHON BioTech Rituximab - 500mg/50ml 500mg/50ml Injectable concentrate for solution 116,417,745 L.L
L01FA01 RUXIENCE BioTech Rituximab - 500mg/50ml 500mg/50ml Injectable concentrate for solution 59,148,151 L.L
J01FA09 RITHROCID G Clarithromycin - 500mg 500mg Tablet, film coated 686,704 L.L
P01AB01 RAMAZOL G Metronidazole - 500mg 500mg Tablet 216,359 L.L
J01DB05 ROXIL G Cefadroxil (monohydrate) - 500mg 500mg Capsule 869,466 L.L
C01EB18 RANEXA B Ranolazine - 500mg 500mg Tablet, prolonged release 3,985,837 L.L
B02BD02 RECOFACT VIII BioTech Moroctocog alfa - 500IU 500IU Injectable powder for solution+diluent 12,049,005 L.L
B02BD04 REFIXIA BioTech Nonacog beta pegol (factor IX) - 500IU 500IU Injectable powder for solution+solvent 76,080,435 L.L
R03DC03 RELIEFAST G Montelukast (sodium) - 4mg 4mg Tablet, chewable 1,034,119 L.L
R03DC03 ROMILAST G Montelukast (sodium) - 4mg 4mg Tablet, mouth dissolving 405,840 L.L
N05AX08 RISPERDAL B Risperidone - 4mg 4mg Tablet, film coated 525,442 L.L
N05AX08 RISPERDAL B Risperidone - 4mg 4mg Tablet, film coated 525,442 L.L
N05AX08 RESPAL 4 G Risperidone - 4mg 4mg Caplet, film coated 557,695 L.L
N05AX08 RISPERIDONE BIOGARAN G Risperidone - 4mg 4mg Tablet, coated, scored 1,105,982 L.L
N05AX08 RISCHOTIC OD 4 G Risperidone - 4mg 4mg Tablet, orally disintegrating 605,369 L.L
C10AC01 RESINCOLESTIRAMINA G Cholestyramine - 4g 4g Powder for suspension 2,998,113 L.L
L03AB07 RECIGEN 44 BioTech Interferon beta-1a - 44mcg/0.5ml 44mcg/0.5ml Injectable solution L.L
L03AB07 RECIGEN 44 BioTech Interferon beta-1a - 44mcg/0.5ml 44mcg/0.5ml Injectable solution 15,147,973 L.L
A02BC01 RISEK G Omeprazole - 40mg 40mg Capsule, enteric coated 522,755 L.L
A02BC01 RISEK G Omeprazole (sodium) - 40mg 40mg Injectable lyophilised powder for solution 592,635 L.L
A02BC02 RAZON 40 G Pantoprazole (sodium) - 40mg 40mg Tablet, enteric coated 727,019 L.L
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