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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
D10AF51 DUAC ONCE DAILY B Clindamycin (phosphate) - 1%, Benzoyl peroxide - 5% Gel 1,658,302 L.L
J07BK01 VARILRIX + SOLVENT IN SYRINGE B Varicella virus, live attenuated - ≥1033 PFU ≥1033 PFU Injectable lyophilised powder for solution+diluent 3,473,833 L.L
L01EJ01 JAKAVI B Ruxolitinib - 15mg 15mg Tablet 341,075,567 L.L
L04AA06 MYFORTIC B Mycophenolic acid (sodium) - 360mg 360mg Tablet, gastroresistant 20,324,991 L.L
N02AX02 TRAMAL 100MG B Tramadol HCl - 100mg/2ml 100mg/2ml Injectable solution 243,235 L.L
N03AX18 VIMPAT B Lacosamide - 100mg 100mg Tablet, film coated 7,835,296 L.L
N06AB08 FAVERIN B Fluvoxamine maleate - 100mg 100mg Tablet, film-scored 1,291,433 L.L
R02AA20 HEXASPRAY COLLUTOIRE PRESSURISE B Biclotymol - 750mg 750mg Spray 353,431 L.L
B03AD04 MALTOFER B Iron trivalent (hydroxide polymaltose) - 10mg/ml 50mg/5ml Syrup 589,947 L.L
C10AA07 CRESTOR B Rosuvastatin (calcium) - 40mg 40mg Tablet, film coated 804,962 L.L
D10AX03 SKINOREN B Azelaic acid - 0.2g/g 0.2g/g Cream 722,987 L.L
J07BK01 VARIVAX B Varicella virus, live attenuated - 1350PFU Injectable powder for suspension+diluent 4,102,751 L.L
L04AA06 CELLCEPT B Mycophenolate mofetil - 250mg 250mg Capsule 6,083,575 L.L
M01AE03 BI-PROFENID LP B Ketoprofen - 100mg 100mg Tablet, prolonged release 392,402 L.L
N06AB10 CIPRALEX B Escitalopram (oxalate) - 10mg 10mg Tablet, film coated 1,548,107 L.L
R03AC02 VENTOLIN EVOHALER B Salbutamol (sulfate) - 100mcg/dose 100mcg/dose Inhalation aerosol metered dose 260,705 L.L
B03AD04 MALTOFER B Iron trivalent (hydroxide polymaltose) - 50mg/ml 50mg/ml Drops solution 649,076 L.L
C09CA08 OLMETEC B Olmesartan medoxomil - 20mg 20mg Tablet, film coated 888,280 L.L
G04CA01 XATRAL XL B Alfuzosin HCl - 10mg 10mg Tablet, prolonged release 1,061,636 L.L
J01DC02 ZINNAT B Cefuroxime (axetil) - 500mg 500mg Tablet, film coated 908,603 L.L
L01EJ01 JAKAVI B Ruxolitinib - 20mg 20mg Tablet 341,075,567 L.L
L04AA06 CELLCEPT B Mycophenolate mofetil - 500mg 500mg Tablet 6,083,575 L.L
M01AE03 PROFENID B Ketoprofen - 100mg 100mg Suppository 321,178 L.L
N03AX18 VIMPAT B Lacosamide - 150mg 150mg Tablet, film coated 11,754,896 L.L
R06AX27 AERIUS B Desloratadine - 5mg 5mg Tablet, film coated 430,030 L.L
B03AD04 MALTOFER B Iron trivalent (hydroxide polymaltose) - 50mg/ml 50mg/ml Drops solution 649,076 L.L
C09CA08 VOTUM B Olmesartan medoxomil - 20mg 20mg Tablet, film coated 954,128 L.L
N03AX18 VIMPAT B Lacosamide - 200mg 200mg Tablet, film coated 13,357,859 L.L
R06AX27 AERIUS B Desloratadine - 5mg 5mg Tablet, film coated 430,030 L.L
L01BC07 VIDAZA B Azacitidine - 100mg 100mg Injectable lyophilised powder L.L
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