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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
A16AB07 MYOZYME BioTech Alglucosidase alfa, recombinant human acid - 50mg 50mg Injectable powder for concentrate for solution 56,536,307 L.L
L01FG01 MVASI BioTech Bevacizumab - 400mg/16ml 400mg/16ml Injectable concentrate for solution 58,035,926 L.L
L01FG01 MVASI BioTech Bevacizumab - 100mg/4ml 100mg/4ml Injectable concentrate for solution 17,173,671 L.L
L01FX02 MYLOTARG BioTech Gemtuzumab Ozogamicin - 4.5mg 4.5mg Injectable powder 748,160,090 L.L
L01FX02 MYLOTARG BioTech Gemtuzumab Ozogamicin - 4.5mg 4.5mg Injectable powder L.L
B01AD11 METALYSE BioTech Tenecteplase - 10,000IU 10,000IU Injectable powder for solution+diluent 77,815,572 L.L
P01AB01 METRONIDAL G Metronidazole benzoate - 125mg/5ml 125mg/5ml Syrup 391,634 L.L
J01CA04 MOXILEN G Amoxicillin (trihydrate) - 500mg 500mg Capsule 3,717,068 L.L
A01AB09 MICONAZ G Miconazole nitrate - 20mg/g 20mg/g Gel 229,093 L.L
A01AB09 MICOZOLE G Miconazole - 20mg/g 20mg/g Gel 104,820 L.L
P01AB01 METROGYL G Metronidazole benzoate - 200mg/5ml 200mg/5ml Powder for suspension 500,867 L.L
A01AB09 MYCOHEAL G Miconazole nitrate - 20mg/g 20mg/g Gel 210,983 L.L
P01AB01 METRIS G Metronidazole - 500mg/100ml 0.50% Injectable solution 142,447 L.L
P01AB01 METRONIDAZOLE G Metronidazole - 500mg/100ml 500mg/100ml Injectable solution 162,605 L.L
P01AB01 METRONIDAZOLE B. BRAUN G Metronidazole - 500mg/100ml 500mg/100ml Injectable solution 102,132 L.L
P01AB01 METRONIDAZOLE FRESENIUS G Metronidazole - 500mg/100ml 500mg/100ml Injectable solution 1,866,597 L.L
P01AB01 METRONIDAZOLE PANPHARMA G Metronidazole - 500mg/100ml 500mg/100ml Injectable solution 1,624,706 L.L
P01AB01 METRONOR G Metronidazole - 500mg/100ml 500mg/100ml Injectable solution 5,359,244 L.L
A06AG11 MINILAX G Sodium citrate (dihydrate) - 900mg/10ml, Sodium lauryl sulfate - 150mg/10ml, Glycerol - 1200mg/10ml, Sorbic acid - 10mg/10ml, Sorbitol - 9.96mg/10ml Solution 474,824 L.L
P01AB01 METRO-SOLUTIONS G Metronidazole - 500mg/100ml 500mg/100ml Injectable solution 166,381 L.L
R05FB02 MUCUS RELIEF DM G Dextromethorphan HBr - 20mg, Guaifenesin - 400mg Tablet 413,903 L.L
R05X MUCOTAL PROMETHAZINE G Promethazine HCl - 2.5mg/5ml, Carbocysteine - 100mg/5ml Syrup 243,172 L.L
J01CA04 MOXILEN G Amoxicillin (sodium) - 1g 1g Injectable dry powder for solution 998,475 L.L
P01AB01 METROLAG G Metronidazole - 500mg 500mg Tablet 389,714 L.L
A02BB01 MISOFAR G Misoprostol - 200mcg 200mcg Tablet 1,546,763 L.L
J01CR02 MOXICLAV G Amoxicillin - 1g, Clavulanic Acid - 200mg 1.2g Injectable powder for solution 169,324 L.L
A02BB01 MISOFAR G Misoprostol - 25mcg 25mcg Tablet 1,855,846 L.L
D07AC13 METASONE G Mometasone furoate - 0.1% 0.10% Cream 335,321 L.L
A07AA02 MEDISTAN G Nystatin - 500,000IU 500,000IU Capsule 417,231 L.L
P01AB01 METROLAG G Metronidazole - 250mg 250mg Tablet 130,353 L.L
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