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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
L01FX07 BLINCYTO BioTech Blinatumomab - 35mcg 35mcg Injectable lyophilised powder for solution+stabilizer 239,484,334 L.L
L01FX07 BLINCYTO BioTech Blinatumomab - 35mcg 35mcg Injectable lyophilised powder for solution+stabilizer L.L
L01AA09 BENDAMUSTINE HYDROCHLORIDE G Bendamustine HCl - 25mg/10ml 25mg/10ml Injectable powder for concentrate for solution 19,610,153 L.L
L01AA09 BENDAMUSTINE MEDAC G Bendamustine HCl - 2.5mg/ml (25mg) 2.5mg/ml Injectable powder for concentrate for solution 24,934,922 L.L
L01AA09 BENDAMUSTINE HYDROCHLORIDE G Bendamustine HCl - 100mg/50ml 100mg/50ml Injectable powder for concentrate for solution 78,439,178 L.L
L01AA09 BENDAMUSTINE HYDROCHLORIDE GP PHARM G Bendamustine HCl - 100mg/50ml 100mg/50ml Injectable powder for concentrate for solution 78,439,178 L.L
L01AA09 BENDAMUSTINE MEDAC G Bendamustine HCl - 2.5mg/ml (100mg) 2.5mg/ml Injectable powder for concentrate for solution 16,887,989 L.L
M03AX01 BOTOX BioTech Clostridium botulinum type A neurotoxin complex - 100U 100U Injectable powder for solution 18,625,995 L.L
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L01XG01 BORTEZOMIB ACCORD G Bortezomib - 3.5mg 3.5mg Injectable powder for solution 13,007,658 L.L
L01XG01 BORTEZOMIB GP PHARM G Bortezomib - 3.5mg 3.5mg Injectable powder for solution 13,007,658 L.L
L01XG01 BORTEZOMIB SPC G Bortezomib - 3.5mg 3.5mg Injectable powder for solution 15,743,401 L.L
L01DC01 BLEO-CELL G Bleomycin (sulfate) - 15mg 15mg Injectable powder for solution 3,817,857 L.L
B02BD04 BENEFIX BioTech Nonacog alfa (recombinant coagulation factor IX) - 500IU 500IU Injectable powder for solution+diluent 27,390,281 L.L
B02BD04 BENEFIX BioTech Nonacog alfa (recombinant coagulation factor IX) - 500IU 500IU Injectable powder for solution+diluent L.L
L01FB01 BESPONSA FOR INJECTION BioTech Inotuzumab Ozogamicin - 0.9mg 0.9mg Injectable powder for suspension 921,176,511 L.L
L01FB01 BESPONSA FOR INJECTION BioTech Inotuzumab Ozogamicin - 0.9mg 0.9mg Injectable powder for suspension L.L
L03AX03 BCG-MEDAC G BCG seed RIVM derived from seed 1173-P2 - 2x10? to 3x10? viable units Injectable powder for suspension+diluent 13,873,850 L.L
L03AX03 BCG-MEDAC G BCG seed RIVM derived from seed 1173-P2 - 2x10? to 3x10? viable units Injectable powder for suspension+diluent L.L
V03AB35 BRIDION B Sugammadex - 200mg/2ml 100mg/ml Injectable solution 54,230,830 L.L
N01BB01 BUPIVACAINE AGUETTANT for spinal anaesthesia G Bupivacaine HCl - 20mg/4ml 20mg/4ml Injectable solution 1,554,826 L.L
N01BB01 BUPIVACAINE HEAVY PANPHARMA G Bupivacaine HCl - 20mg/4ml 20mg/4ml Injectable solution 2,586,897 L.L
N01BB01 BUPIVACAINE AGUETTANT 2.5MG/ML G Bupivacaine HCl - 50mg/20ml 50mg/20ml Injectable solution 2,736,063 L.L
N01BB01 BUPIVACAINE AGUETTANT 5MG/ML G Bupivacaine HCl - 100mg/20ml 100mg/20ml Injectable solution 3,078,743 L.L
V03AF03 BENDAFOLIN G Calcium folinate - 200mg/20ml 200mg/20ml Injectable solution 3,584,028 L.L
L03AB07 BLASTOFERON BioTech Interferon beta-1a - 44mcg 44mcg Injectable solution 55,847,685 L.L
L03AB07 BLASTOFERON BioTech Interferon beta-1a - 22mcg 22mcg Injectable solution 40,725,735 L.L
L01FG01 BEVACIREL BioTech Bevacizumab - 400mg/16ml 400mg/16ml Injectable solution L.L
L01FG01 BEVACIREL BioTech Bevacizumab - 100mg/4ml 100mg/4ml Injectable solution L.L
B03XA01 BINOCRIT BioTech Erythropoietin recombinant human (Epoetin alfa) - 2,000IU/ml 2,000IU/ml Injectable solution 6,803,873 L.L
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