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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
N02BE01 MAKOACHE G Paracetamol - 1000mg/100ml 10mg/ml Injectable solution 1,403,867 L.L
A10BX16 MOUNJARO KWIKPEN B Tirzepatide - 12.5mg/dose 12.5mg/dose Injectable solution 39,601,065 L.L
H01BA02 MINIRIN MELT B Desmopressin - 120mcg 120mcg Tablet, Oral lyophilisate 4,970,873 L.L
H02AB04 METHYL PREDNISOLONE VIATRIS 120MG G Methylprednisolone (hemisuccinate) - 120mg 120mg Injectable dry powder for solution 602,536 L.L
L04AX07 MAROVAREX G Dimethyl Fumarate - 120mg 120mg Capsule, hard, gastro-resistant 9,838,676 L.L
H02AB04 METHYLPREDNISOLONE ORBUCELL INJ. G Methylprednisolone sodium succinate - 125mg 125mg Injectable powder for solution 5,784,922 L.L
P01AB01 METRONIDAL G Metronidazole benzoate - 125mg/5ml 125mg/5ml Syrup 391,634 L.L
P01AB01 METROLAG G Metronidazole benzoate - 125mg/5ml 125mg/5ml Syrup 391,634 L.L
P01AB01 METROLE G Metronidazole benzoate - 125mg/5ml 125mg/5ml Syrup 391,634 L.L
G03GA02 MENO-CLAIR HP-HMG BioHuman Human Menopausal Gonadotrophin, Highly purified - 150IU 150IU Injectable powder for solution + solution 2,005,013 L.L
G03GA02 MERIONAL HG BioHuman Menotropin - 150IU 150IU Injectable powder + solvent 41,777,992 L.L
L01EB02 MIRATA G Erlotinib (HCl) - 150mg 150mg Tablet, film coated 88,599,923 L.L
J02AC01 MYXEN G Fluconazole - 150mg 150mg Tablet 255,970 L.L
M03BX04 MYDOCALM B Tolperisone - 150mg 150mg Tablet, film coated 839,902 L.L
B05XA05 MAGNESIUM SULFATE G Magnesium sulfate, 7H2O - 15g/100ml 15g/100ml Injectable solution 756,160 L.L
G04BD06 MICTONORM B Propiverine HCl - 15mg 15mg Tablet, coated 1,261,868 L.L
L01EE03 MEKTOVI BioTech Binimetinib - 15mg 15mg Tablet, film coated 257,694,409 L.L
L04AX03 METOJECT G Methotrexate disodium - 15mg/0.3ml 15mg/0.3ml Injectable solution 1,968,729 L.L
R05CB06 MUCUM G Ambroxol HCl - 15mg/5ml 15mg/5ml Syrup, sugar free, alcohol free 98,101 L.L
A10BX16 MOUNJARO KWIKPEN B Tirzepatide - 15mg/dose 15mg/dose Injectable solution 39,601,065 L.L
J01CA04 MOXILEN G Amoxicillin (sodium) - 1g 1g Injectable dry powder for solution 998,475 L.L
J01CR02 MEGAMOX-JPI G Amoxicillin (trihydrate) - 875mg, Clavulanic Acid (potassium) - 125mg 1g Tablet 456,906 L.L
J01CR02 MOXICLAV G Amoxicillin (trihydrate) - 875mg, Clavulanic Acid (potassium) - 125mg 1g Tablet 430,030 L.L
A10BA02 MINOR G Metformin HCl - 1g 1g Tablet 266,209 L.L
J01DD04 MEDAXONUM G Ceftriaxone (disodium) - 1g 1g Injectable powder for solution+diluent 438,093 L.L
J01DD04 MEDAXONUM G Ceftriaxone (disodium) - 1g 1g Injectable powder for solution 15,482,229 L.L
H02AB04 METHYL PREDNISOLONE VIATRIS 1G G Methylprednisolone (hemisuccinate) - 1g 1g Injectable dry powder for solution 1,348,604 L.L
J01DH02 MERONEM B Meropenem (trihydrate) - 1g 1g Injectable powder for solution 10,398,061 L.L
J01DH02 MEROLIN G Meropenem (trihydrate) - 1g 1g Injectable powder for solution 2,402,668 L.L
J01DH02 MEROPENEM LABATEC G Meropenem (trihydrate) - 1g 1g Injectable powder for solution 7,278,513 L.L
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