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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
N02CC03 ZOLMITRIPTAN BIOGARAN G Zolmitriptan - 2.5mg 2.5mg Tablet, orodispersible 921,876 L.L
N02CC03 ZOLMITRIPTAN BIOGARAN G Zolmitriptan - 2.5mg 2.5mg Tablet, orodispersible 1,683,835 L.L
J01FA10 ZOMAX G Azithromycin (dihydrate) - 200mg/5ml 200mg/5ml Powder for suspension 258,018 L.L
J05AB01 ZOVIRAX B Aciclovir - 200mg/5ml 200mg/5ml Suspension 487,815 L.L
L01XX44 ZALTRAP BioTech Aflibercept - 200mg/8ml 200mg/8ml Injectable concentrate for solution 63,807,499 L.L
L01XX44 ZALTRAP BioTech Aflibercept - 200mg/8ml 200mg/8ml Injectable concentrate for solution 63,807,499 L.L
B01AF01 ZARLAN G Rivaroxaban - 20mg 20mg Tablet, film coated 1,343,843 L.L
N06AB10 ZELAX 20 G Escitalopram (oxalate) - 20mg 20mg Caplet 1,544,075 L.L
C09AA03 ZESTRIL B Lisinopril (dihydrate) - 20mg 20mg Tablet 636,981 L.L
C10AA01 ZOCOR B Simvastatin - 20mg 20mg Tablet 976,526 L.L
D06AX01 ZETA G Fusidic acid - 20mg/g 20mg/g Cream 178,731 L.L
L01EC01 ZELBORAF B Vemurafenib - 240mg 240mg Tablet, film coated 142,041,587 L.L
L01EC01 ZELBORAF B Vemurafenib - 240mg 240mg Tablet, film coated L.L
C08DB01 ZALDEM CR G Diltiazem HCl - 240mg 240mg Capsule, controlled release 1,002,123 L.L
J01FA10 ZITHROMAX B Azithromycin (dihydrate) - 250mg 250mg Capsule 591,291 L.L
J01FA10 ZETRON G Azithromycin (dihydrate) - 250mg 250mg Capsule 360,150 L.L
J01FA10 ZEVLEN G Azithromycin (dihydrate) - 250mg 250mg Tablet, film coated 409,552 L.L
J01FA10 ZIMAX G Azithromycin (dihydrate) - 250mg 250mg Capsule 360,150 L.L
J01FA10 ZOMAX G Azithromycin (dihydrate) - 250mg 250mg Capsule 360,150 L.L
J01DC02 ZINNAT B Cefuroxime (axetil) - 250mg 250mg Tablet, film coated 349,399 L.L
J05AB01 ZOVIRAX IV B Aciclovir - 250mg 250mg Injectable freeze dried substance 2,146,116 L.L
J01DC02 ZINNAT B Cefuroxime (axetil) - 250mg/5ml 250mg/5ml Granules for suspension 1,120,782 L.L
A10BD07 ZERILUX G Sitagliptin - 25mg/ml 25mg/ml Solution 1,172,179 L.L
L02AE03 ZOLADEX DEPOT B Goserelin (acetate) - 3.6mg 3.6mg Injectable suspension 8,820,074 L.L
C09CA04 ZIOREL G Irbesartan - 300mg 300mg Tablet, film coated 575,933 L.L
M04AA01 ZYLORIC B Allopurinol - 300mg 300mg Tablet 302,365 L.L
J01FA10 ZITHROMAX B Azithromycin (dihydrate) - 300mg/7.5ml 300mg/7.5ml Powder for suspension 489,159 L.L
L03AA02 ZARZIO BioTech Filgrastim - 300mcg/0.5ml 30MU/0.5ml Injectable solution 13,053,190 L.L
L03AA02 ZARZIO BioTech Filgrastim - 300mcg/0.5ml 30MU/0.5ml Injectable solution 13,053,190 L.L
P02CA03 ZENTEL B Albendazole - 400mg 400mg Tablet 169,324 L.L
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