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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
N03AX12 GABAPENTINE ARROW GENERIQUES G Gabapentin - 400mg 400mg Capsule 1,342,499 L.L
A11AA VITA-GERIN G Ginseng extract - 40mg, Vitamin A, palmitate - 2667IU, Vitamin D3 - 200IU, ?-Tocopheryl acetate - 10mg, Thiamine mononitrate - 1.4mg, Riboflavine - 1.6mg, Pyridoxine HCl - 2mg, Cyanocobalamin - 1mcg, Biotin - 150mcg, Nicotinamide - 18mg, Ascorbic acid - 60mg, Folic acid - 100mcg, Calcium phosphate - 100mg, Lecithin - 100mg, Magnesium sulfate - 10mg, Iron sulphate - 10mg, Copper sulfate - 2mg, Sodium selenite anhydrous - 50mcg, Zinc sulfate - 1mg Capsule 1,724,150 L.L
C04AX21 NAFTILUX B Naftidrofuryl oxalate acid - 200mg 200mg Capsule 432,717 L.L
N03AX12 GABATREX G Gabapentin - 400mg 400mg Capsule 1,846,440 L.L
A07FA02 ULTRA LEVURE B Saccharomyces boulardii - 50mg 50mg Capsule 381,651 L.L
N03AX12 NEUROPLEX G Gabapentin - 400mg 400mg Capsule 1,290,089 L.L
A07FA02 ULTRA LEVURE B Saccharomyces boulardii - 200mg 200mg Capsule 513,348 L.L
A11AA PANTOGAR B P-aminobenzoic acid - 20mg, Keratine - 20mg, Medical yeast - 100mg, Thiamine mononitrate - 60mg, L-Cystine - 20mg, Calcium D-pantothenate - 60mg Capsule 2,005,013 L.L
N03AX12 PMS-GABAPENTIN G Gabapentin - 400mg 400mg Capsule 1,071,042 L.L
N06AB03 FLUOXETINE BIOGARAN G Fluoxetine (HCl) - 20mg 20mg Capsule 239,204 L.L
N03AX12 GABATREX G Gabapentin - 100mg 100mg Capsule 292,958 L.L
N06AB03 NEANXETIN G Fluoxetine (HCl) - 20mg 20mg Capsule 422,351 L.L
A07FA51 INFLORAN B Bifidobacterium infantis - 1milliard, Lactobacillus acidophilus - 1milliard Capsule 647,732 L.L
B02BX01 DICYNONE B Etamsylate - 500mg 500mg Capsule 1,311,590 L.L
L01EF01 IBRANCE B Palbociclib - 75mg 75mg Capsule 172,164,216 L.L
M01AE01 ADVIL LIQUI-GELS B Ibuprofen - 200mg 200mg Capsule 464,970 L.L
N06AB03 PMS-FLUOXETINE G Fluoxetine (HCl) - 20mg 20mg Capsule 592,635 L.L
N06AB03 PROXETIN G Fluoxetine (HCl) - 20mg 20mg Capsule 374,996 L.L
A07XA04 RACECADOTRIL ARROW G Racecadotril - 100mg 100mg Capsule 583,228 L.L
L01EF01 PALBRANCE 75 G Palbociclib - 75mg 75mg Capsule 168,011,222 L.L
N06AB03 FLUTIN G Fluoxetine (HCl) - 20mg 20mg Capsule 362,837 L.L
A07XA04 RACECADOTRIL BGR G Racecadotril - 100mg 100mg Capsule 575,165 L.L
J07AX URO-VAXOM B Lyophilized bacterial lysates of E-Coli - 6mg 6mg Capsule 2,689,029 L.L
A07XA04 RACECADOTRIL BIOGARAN CONSEIL G Racecadotril - 100mg 100mg Capsule 287,582 L.L
A11CC03 ONE-ALPHA B Alfacalcidol - 1mcg 1mcg Capsule 3,735,882 L.L
J07AX BRONCHO-VAXOM CHILDREN B Lyophilized bacterial lysates of Haemophilus influenzae, Diplococcus pneumoniae, Klebsiella pneumoniae and ozaenae, Staphylococcus aureus, Streptococcus pyogenes and viridans, Neisseria catarrhalis - 3.5mg Capsule 1,988,887 L.L
L01EF01 IBRANCE B Palbociclib - 100mg 100mg Capsule 172,164,216 L.L
J07AX BRONCHO-VAXOM ADULTS B Lyophilized bacterial lysates of Haemophilus influenzae, Diplococcus pneumoniae, Klebsiella pneumoniae and ozaenae, Staphylococcus aureus, Streptococcus pyogenes and viridans, Neisseria catarrhalis - 7mg Capsule 2,746,814 L.L
A11CC03 ONE-ALPHA B Alfacalcidol - 0.25mcg 0.25mcg Capsule 1,138,235 L.L
L01EF01 PALBOMED G Palbociclib - 100mg 100mg Capsule 23,911,751 L.L
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