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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
D08AX02 EOSIN ALCOHOLIC G Eosin - 1% 1% Solution 108,787 L.L
D08AX02 EOSIN AQUEUSE G Eosin - 1% 1% Solution 84,470 L.L
D11AH02 ELIDEL B Pimecrolimus - 10mg/g 1% Cream 1,780,591 L.L
D01AC03 ECONAZ G Econazole nitrate - 1% 1% Cream 307,164 L.L
D01AE22 EXODERIL B Naftifine HCl - 10mg/g 1% Cream 345,368 L.L
D01AE22 EXODERIL B Naftifine HCl - 10ml/ml 1% Solution 159,917 L.L
D10AF02 ERYTHROMYCIN 1.5 % G Erythromycin - 15mg/ml 1.50% Solution 501,701 L.L
A12BA01 EURO-K G Potassium chloride - 1.5g 1.5g Tablet, sustained release 894,999 L.L
A11CC05 EURO D 10000 IU G Vitamin D3 - 10,000IU 10,000IU Capsule 993,100 L.L
L01XX02 ERWINASE BioTech Erwinia L-asparaginase - 10,000IU 10,000IU Injectable lyophilised powder for solution 444,434,845 L.L
B01AB05 ENOXAMED BioTech Enoxaparin sodium - 10000IU Anti-XA/1ml 10000IU Anti-XA/1ml Injectable solution 1,209,458 L.L
B03XA01 EPOMAX BioTech Erythropoietin recombinant human (Epoetin alfa) - 10000UI/ml 10000UI/ml Injectable solution 2,486,109 L.L
B02BD02 ESPEROCT BioTech Turoctocog Alfa pegol (recombinant coagulation factor VIII) - 1000IU/Vial 1000IU/Vial Injectable powder for solution+diluent 75,761,046 L.L
H03AA01 ELTROXIN B Levothyroxine sodium - 100mcg 100mcg Tablet, scored 440,780 L.L
H03AA01 EUTHYROX B Levothyroxine sodium - 100mcg 100mcg Tablet, scored 452,875 L.L
G03GA09 ELONVA BioHuman Corifollitropin alfa - 100mcg/0.5ml 100mcg/0.5ml Injectable solution 35,131,802 L.L
L01FD04 ENHERTU BioTech Trastuzumab deruxtecan - 100mg 100mg Injectable powder for concentrate for solution 178,517,964 L.L
J02AX06 ECALTA B Anidulafungin - 100mg 100mg Injectable concentrated powder for solution 16,977,343 L.L
G03DA04 ENDOMETRIN B Progesterone - 100mg 100mg Tablet 2,776,379 L.L
N03AB02 EPANUTIN B Phenytoin sodium - 100mg 100mg Capsule 739,113 L.L
N03AB02 EPANUTIN B Phenytoin sodium - 100mg 100mg Capsule 739,113 L.L
L01FE01 ERBITUX BioTech Cetuximab - 100mg/20ml 100mg/20ml Injectable solution L.L
L01FE01 ERBITUX BioTech Cetuximab - 100mg/20ml 100mg/20ml Injectable solution 24,952,249 L.L
L01CB01 ETOPOSIDE EBEWE G Etoposide - 100mg/5ml 100mg/5ml Injectable concentrated solution 768,678 L.L
L01CB01 ETOPOSIDE VIATRIS 20MG/ML G Etoposide - 100mg/5ml 100mg/5ml Injectable concentrated solution 1,544,466 L.L
L01CB01 ETOPOSIDE VIATRIS 20MG/ML G Etoposide - 100mg/5ml 100mg/5ml Injectable concentrated solution L.L
M05BX06 EVENITY BioTech Romosozumab - 105mg/1.17ml 105mg/1.17ml Injectable solution 56,729,091 L.L
L04AA33 ENTYVIO BioTech Vedolizumab - 108mg 108mg Injectable solution 92,478,560 L.L
L04AA33 ENTYVIO BioTech Vedolizumab - 108mg 108mg Injectable solution 92,478,560 L.L
J07BC01 ENGERIX-B 10 B Hepatitis B, surface antigen - 10mcg/0.5ml 10mcg/0.5ml Injectable suspension 1,042,822 L.L
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