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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
L02AE04 GONAPEPTYL CR B Triptorelin - 3.75mg 3.75mg Injectable powder for suspension+diluent 12,095,730 L.L
C02KX04 OPSUMIT B Macitentan - 10mg 10mg Tablet, film coated 201,006,231 L.L
J01CR02 AUGMENTIN B Amoxicillin (trihydrate) - 125mg/5ml, Clavulanic Acid (potassium) - 31.25mg/5ml 156.25mg/5ml Powder for suspension 302,365 L.L
J05AX18 PREVYMIS B Letermovir - 240mg 240mg Tablet, film coated 460,943,945 L.L
N03AG04 SABRIL B Vigabatrin - 500mg 500mg Tablet, film coated 2,988,706 L.L
B01AF02 ELIQUIS B Apixaban - 2.5mg 2.5mg Tablet, film coated 4,183,603 L.L
C02LA51 ADELPHAN ESIDREX B Reserpine - 0.1mg, Hydrochlorothiazide - 10mg, Dihydralazine - 10mg Tablet 371,157 L.L
D07AC13 ELOCOM B Mometasone furoate - 1mg/g 0.10% Lotion 282,207 L.L
J05AX18 PREVYMIS B Letermovir - 480mg 480mg Tablet, film coated 961,233,292 L.L
V03AC03 JADENU B Deferasirox - 180mg 180mg Tablet, film coated 27,151,164 L.L
A07AA11 NORMIX TAB B Rifaximin alpha - 200mg 200mg Tablet, film coated 827,807 L.L
C03AA03 ESIDREX B Hydrochlorothiazide - 25mg 25mg Tablet 380,115 L.L
G04BD08 VESICARE B Solifenacin succinate - 10mg 10mg Tablet, film coated 1,619,330 L.L
J01CR02 AUGMENTIN B Amoxicillin (trihydrate) - 250mg/5ml, Clavulanic Acid (potassium) - 62.5mg/5ml 312.5mg/5ml Powder for suspension 542,912 L.L
J05AX18 PREVYMIS B Letermovir - 240mg/12ml 240mg/12ml Injectable concentrate for solution 23,599,640 L.L
A07AA11 NORMIX SIROP B Rifaximin alpha - 100mg/5ml 100mg/5ml Granules for suspension 477,064 L.L
C03BA04 HYGROTON B Chlortalidone - 50mg 50mg Tablet 422,351 L.L
C09BX01 TRIPLIXAM B Perindopril arginine - 5mg, Indapamide - 1.25mg, Amlodipine - 5mg Tablet, film coated 968,910 L.L
L02BA03 FASLODEX B Fulvestrant - 250mg/5ml 250mg/5ml Injectable solution 46,628,557 L.L
A07AA12 DIFICLIR B Fidaxomicin - 200mg 200mg Tablet, film coated 135,347,725 L.L
C03BA11 FLUDEX B Indapamide - 1.5mg 1.5mg Tablet, sustained release 517,379 L.L
C09BX01 TRIPLIXAM B Perindopril arginine - 10mg, Indapamide - 2.5mg, Amlodipine - 5mg Tablet, film coated 1,237,679 L.L
D07AC14 ADVANTAN B Methylprednisolone aceponate - 1mg/g 1mg/g Ointment 385,683 L.L
L01EA02 SPRYCEL B Dasatinib - 50mg 50mg Tablet 212,274,841 L.L
N01AH06 ULTIVA B Remifentanil (HCl) - 5mg 5mg Injectable powder for solution 2,990,050 L.L
N03AX09 LAMICTAL B Lamotrigine - 100mg 100mg Tablet 2,741,209 L.L
N05BA08 LEXOTANIL B Bromazepam - 3mg 3mg Tablet, scored 413,903 L.L
R05X ACTISOUFRE B Sulfure de Sodium - 13mg, Saccharomyces Cerevisiae - 500mg Solution 740,457 L.L
V03AC03 JADENU B Deferasirox - 360mg 360mg Tablet, film coated 27,151,500 L.L
A10BH04 VIPIDIA B Alogliptin benzoate - 25mg 25mg Tablet, film coated 2,998,113 L.L
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