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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
J01FA09 KLACID B Clarithromycin - 125mg/5ml 125mg/5ml Granules for suspension 575,165 L.L
L01XK04 TALZENNA B Talazoparib - 1mg 1mg Capsule 401,512,167 L.L
L04AA29 XELJANZ B Tofacitinib - 5mg 5mg Tablet L.L
A06AD65 MOVICOL PEDIATRIC PLAIN B Potassium chloride - 23.3mg, Sodium chloride - 175.4mg, Sodium bicarbonate - 89.3mg, Macrogol 3350 - 6.563g Powder for solution 624,887 L.L
C02AB02 ALDOMET B Methyldopa - 250mg 250mg Tablet, coated 644,400 L.L
C09BB02 ZANIPRESS B Lercanidipine HCl - 10mg, Enalapril maleate - 20mg Tablet, film coated 2,548,821 L.L
G04BD06 MICTONORM B Propiverine HCl - 15mg 15mg Tablet, coated 1,261,868 L.L
L01DC01 BLEOCIN B Bleomycin (sulfate) - 15U 15U Injectable lyophilised powder for solution 2,109,833 L.L
L01XK04 TALZENNA B Talazoparib - 0.25mg 0.25mg Capsule 133,836,699 L.L
M05BA04 FOSAMAX 70MG ONCE WEEKLY B Alendronate - 70mg 70mg Tablet 1,988,887 L.L
S01GA51 NAPHCON A B Naphazoline HCl - 0.025%, Pheniramine maleate - 0.3% Drops solution 369,557 L.L
A10BG03 ACTOS B Pioglitazone HCl - 15mg 15mg Tablet 1,243,054 L.L
C02AB02 ALDOMET B Methyldopa - 500mg 500mg Tablet, coated 856,708 L.L
C09BB02 ZANIPRESS B Lercanidipine HCl - 10mg, Enalapril maleate - 10mg Tablet, film coated 2,280,949 L.L
G04BD06 MICTONORM XL B Propiverine HCl - 30mg 30mg Capsule, modified release 1,648,895 L.L
J01FA09 KLACID B Clarithromycin - 250mg/5ml 250mg/5ml Granules for suspension 1,698,617 L.L
J05AP55 EPCLUSA B Sofosbuvir - 400mg, Velpatasvir - 100mg Tablet, film coated 991,921,769 L.L
L01XK52 AKEEGA B Niraparib - 100mg, Abiraterone acetate - 500mg Tablet, film coated 519,366,124 L.L
N05AX08 RISPERDAL B Risperidone - 4mg 4mg Tablet, film coated 525,442 L.L
N07BC01 BUVIDAL B Buprenorphine - 8mg 8mg Injectable solution prolonged release 8,524,771 L.L
C02AC05 CYNT B Moxonidine - 0.2mg 0.2mg Tablet, film coated 937,444 L.L
C09BB04 COVERAM B Perindopril arginine - 5mg, Amlodipine - 5mg Tablet 821,088 L.L
G04BD06 MICTONORM XL B Propiverine HCl - 45mg 45mg Capsule, modified release 1,877,348 L.L
J05AP56 VOSEVI B Sofosbuvir - 400mg, Velpatasvir - 100mg, Voxilaprevir - 100mg Tablet, film coated 891,634,849 L.L
L01XK52 AKEEGA B Niraparib - 50mg, Abiraterone acetate - 500mg Tablet, film coated 519,366,124 L.L
N05AX08 RISPERDAL B Risperidone - 4mg 4mg Tablet, film coated 525,442 L.L
N07BC01 BUVIDAL B Buprenorphine - 16mg 16mg Injectable solution prolonged release 8,524,771 L.L
R05CA12 PROSPAN ACUTE EFFERVESCENT COUGH TABLETS B Dried Ivy leaf extract - 65mg Tablet, effervescent 479,752 L.L
S01GX02 LEVOPHTA B Levocabastine HCl - 0.5mg/ml 0.05% Suspension 682,672 L.L
A02BB01 CYTOTEC B Misoprostol - 200mcg 200mcg Tablet 737,770 L.L
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