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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
L01EB01 IRESSA B Gefitinib - 250mg 250mg Tablet, fim coated 135,027,509 L.L
A07FA51 INFLORAN B Bifidobacterium infantis - 1milliard, Lactobacillus acidophilus - 1milliard Capsule 647,732 L.L
L01EF01 IBRANCE B Palbociclib - 75mg 75mg Capsule 172,164,216 L.L
L01EF01 IBRANCE B Palbociclib - 75mg 75mg Tablet, film coated 172,164,216 L.L
L01EF01 IBRANCE B Palbociclib - 100mg 100mg Capsule 172,164,216 L.L
L01EF01 IBRANCE B Palbociclib - 100mg 100mg Tablet, film coated 172,164,216 L.L
J07BB01 INFLUVAC TETRA B Influenza virus surface antigens inactivated (haemagglutinin and neuraminidase) - 15mcg/4strains/0.5ml Injectable suspension 970,254 L.L
L01EF01 IBRANCE B Palbociclib - 125mg 125mg Capsule 172,164,216 L.L
J07BB02 INFLUVAC B Grippal virus surface antigen 3strains - 15mcgx3strains/0.5ml Injectable suspension 573,821 L.L
L01EF01 IBRANCE B Palbociclib - 125mg 125mg Tablet, film coated 172,164,216 L.L
L01EL01 IMBRUVICA B Ibrutinib - 420mg 420mg Tablet, film coated L.L
L01EK01 INLYTA B Axitinib - 5mg 5mg Tablet, film coated 184,486,511 L.L
L01EK01 INLYTA B Axitinib - 1mg 1mg Tablet, film coated 57,595,789 L.L
L01EL01 IMBRUVICA B Ibrutinib - 140mg 140mg Tablet, film coated 194,761,420 L.L
J07CA06 INFANRIX IPV + HIB B Poliomyelitis virus type 3 inactivated(Prefilled syringe) - 32D.U., Poliomyelitis virus type 2 inactivated(Prefilled syringe) - 8D.U., Poliomyelitis virus type 1 inactivated(Prefilled syringe) - 40D.U., Bordetella pertussis antigen(Prefilled syringe) - toxoid 25mcg+filamentous haemaglutinin 25mcg+pertactin 8mcg, Tetanus toxoid (Prefilled syringe) - ?40IU, Diphtheria toxoid (Prefilled syringe) - ?30IU, H. Influenza type b polysaccharide(Vial) - 10mcg Injectable dry powder+suspension 3,014,239 L.L
L01EL01 IMBRUVICA B Ibrutinib - 420mg 420mg Tablet, film coated 584,283,050 L.L
L04AX06 IMNOVID B Pomalidomide - 4mg 4mg Capsule, hard L.L
J07CA09 INFANRIX HEXA B Diphteria toxoid purified (Prefilled syringe) - ?30IU/0.5ml, Tetanus toxoid purified (prefilled syringe) - ?40IU/0.5ml, Bordetella pertussis antigen (Prefilled syringe) - toxoid 25mcg+filamentous haemaglutinin 25mcg+pertactin 8mcg/0.5ml, Poliomyelitis virus type 1 antigen (prefilled syringe) - 40D.U./0.5ml, Poliomyelitis virus type 2 antigen(prefilled syringe) - 8D.U./0.5ml, Poliomyelitis virus type 3 antigen (prefilled syringe) - 32D.U./0.5ml, HBs Antigen (prefilled syringe) - 10mcg/0.5ml, H. Influenza type b polysaccharide (Vial) - 10mcg/0.5ml Injectable suspension 4,230,416 L.L
R07AA INFASURF B Calfactant - 210mg/6ml 35mg/ml Injectable suspension 40,596,749 L.L
R07AA INFASURF B Calfactant - 105mg/3ml 35mg/ml Injectable suspension 23,344,161 L.L
R03AK08 INUVER B Formoterol fumarate - 6mcg/dose, Beclometasone dipropionate - 100mcg/dose Inhalation solution 3,493,991 L.L
R03AK08 INUVER NEXTHALER B Formoterol fumarate dihydrate - 6mcg/dose, Beclometasone dipropionate - 100mcg/dose Inhalation powder 4,380,927 L.L
S01BA15 ILUVIEN B Fluocinolone acetonide - 0.19mg 0.19mg Implant 629,182,630 L.L
S01BC01 INDOCOLLYRE B Indometacine - 5mg/5ml 0.10% Drops 408,528 L.L
G03AC08 IMPLANON NXT B Etonogestrel - 68mg 68mg Implant 12,299,971 L.L
L04AX01 IMURAN B Azathioprine - 50mg 50mg Tablet 2,030,546 L.L
C08DA01 ISOPTIN B Verapamil (HCl) - 80mg 80mg Tablet, film coated 397,704 L.L
C08DA01 ISOPTIN SR B Verapamil (HCl) - 240mg 240mg Tablet, film coated, prolonged release 1,128,821 L.L
A10BD09 INCRESYNC B Pioglitazone - 15mg, Alogliptin - 25mg Tablet, film coated 3,897,143 L.L
J01DH03 INVANZ B Ertapenem - 1g 1g Injectable concentrated powder for solution 3,785,604 L.L
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