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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
M01AH05 ARTRIX 90 G Etoricoxib - 90mg 90mg Tablet, film coated 1,228,656 L.L
C09DA04 ANDARAN PLUS G Irbesartan - 300mg, Hydrochlorothiazide - 12.5mg Tablet, film coated 598,051 L.L
C10BA05 ATOZET B Atorvastatin - 20mg, Ezetimibe - 10mg Tablet, film coated 2,046,672 L.L
C10BA05 ATOZET B Atorvastatin - 40mg, Ezetimibe - 10mg Tablet, film coated 2,046,672 L.L
C10BA05 ATOZET B Atorvastatin - 40mg, Ezetimibe - 10mg Tablet, film coated 2,046,672 L.L
C09DA04 ANDARAN PLUS G Irbesartan - 300mg, Hydrochlorothiazide - 25mg Tablet, film coated 940,435 L.L
M01AH05 ARCOXIA B Etoricoxib - 120mg 120mg Tablet, film coated 603,385 L.L
M01AH05 ARTRIX 120 G Etoricoxib - 120mg 120mg Tablet, film coated 511,940 L.L
C09DB01 ANGIOSAR G Amlodipine besylate - 10mg, Valsartan - 160mg Tablet, film coated 857,372 L.L
N06DA02 ARICEPT B Donepezil HCl - 5mg 5mg Tablet, film coated 3,254,787 L.L
N06DA02 ARIPEZIL 5 G Donepezil HCl - 5mg 5mg Tablet, film coated 1,970,969 L.L
N06DA02 ARICEPT B Donepezil HCl - 10mg 10mg Tablet, film coated 3,776,197 L.L
N06DA02 ARIPEZIL 10 G Donepezil HCl - 10mg 10mg Tablet, film coated 2,292,595 L.L
R03DC03 AIRFAST G Montelukast (sodium) - 10mg 10mg Tablet, film coated 802,274 L.L
N02BE51 A.B.C.-COLD G Paracetamol - 500mg, Chlorphenamine maleate - 4mg, Phenylephrine HCl - 5mg Tablet, film coated 534,977 L.L
B01AC04 AGGRIX 75 G Clopidogrel besylate - 75mg 75mg Tablet, film coated 1,204,083 L.L
B01AC04 ANTIPLEX G Clopidogrel (Bisulfate) - 75mg 75mg Tablet, film coated 1,295,464 L.L
A10BD05 ACTOSMET B Metformin - 850mg, Pioglitazone - 15mg Tablet, film coated 3,101,588 L.L
C09DX01 ANGIOSAR PLUS G Valsartan - 320mg, Amlodipine - 10mg, Hydrochlorothiazide - 25mg Tablet, film coated 1,689,210 L.L
M04AA03 ADENURIC B Febuxostat - 120mg 120mg Tablet, film coated 2,184,704 L.L
M04AA03 ADENURIC B Febuxostat - 40mg 40mg Tablet, film coated 1,687,866 L.L
J05AF10 AVIRAVIR G Entecavir monohydrate - 1mg 1mg Tablet, film coated 32,224,230 L.L
J05AF10 AVIRAVIR G Entecavir monohydrate - 0.5mg 0.5mg Tablet, film coated 32,224,230 L.L
N02CC05 ALMOVITAE G Almotriptan - 12.5mg 12.5mg Tablet, film coated 1,148,985 L.L
L01XK52 AKEEGA B Niraparib - 100mg, Abiraterone acetate - 500mg Tablet, film coated 519,366,124 L.L
L01XK52 AKEEGA B Niraparib - 50mg, Abiraterone acetate - 500mg Tablet, film coated 519,366,124 L.L
C10AA05 ATOR MEDIS G Atorvastatin - 10mg 10mg Tablet, film coated 305,052 L.L
C10AA05 ATORLIP 10 G Atorvastatin (calcium) - 10mg 10mg Tablet, film coated 1,052,037 L.L
G04CA01 ALFOCIN G Alfuzosin HCl - 10mg 10mg Tablet, extended release 858,779 L.L
A07EC02 ASACOL B Mesalazine - 400mg 400mg Tablet, enteric coated 5,895,437 L.L
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