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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
M02AA31 ROXONIN TAPE B Loxoprofen Sodium Hydrate - 100mg 100mg Patch 896,343 L.L
J01AA02 RETADOX G Doxycycline (hyclate) - 100mg 100mg Capsule 209,895 L.L
A10AD06 RYZODEG BioTech Insulin degludec - 70%, Insulin aspart - 30% 100IU/ml Injectable solution 7,058,661 L.L
J06BB05 RABISHIELD-100 (RABIES HUMAN MONOCLONAL ANTIBODY rDNA) BioHuman Rabies, Human IgG1 Monoclonal Antibody - 100IU/2.5ml 100IU/2.5ml 8,455,824 L.L
B02BD04 REFIXIA BioTech Nonacog beta pegol (factor IX) - 1000IU 1000IU Injectable powder for solution+solvent 149,006,276 L.L
J01FA02 ROVAMYCINE B Spiramycin - 1.5MIU 1.5MIU Tablet, film coated 256,674 L.L
N05AX15 REAGILA G Cariprazine HCl - 1.5mg 1.5mg Capsule, hard 6,394,003 L.L
C03BA11 RAWEL SR G Indapamide - 1.5mg 1.5mg Tablet, prolonged release 362,837 L.L
N06DA03 RIVASTIGMINE ARROW G Rivastigmine - 1.5mg 1.5mg Capsule 684,016 L.L
N06DA03 RIVASTIGMINE ARROW G Rivastigmine - 1.5mg 1.5mg Capsule 684,016 L.L
B02BD08 RECOFACT VII BioTech Eptacog alfa (activated) recombinant - 1.2mg 1.2mg Injectable powder for solution+diluent 47,533,131 L.L
D06BX01 ROZEX B Metronidazole - 0.75g/100g 0.75% Gel 584,571 L.L
R06AX27 RINA 5 G Desloratadine - 5mg 0.5mg/ml Tablet, film coated 134,384 L.L
R06AX27 RINA G Desloratadine - 0.5mg/ml 0.5mg/ml Syrup 159,917 L.L
N03AE01 RIVOTRIL B Clonazepam - 0.5mg 0.5mg Tablet, scored 403,153 L.L
A10BX02 REPAGLINIDE ARROW LAB G Repaglinide - 0.5mg 0.5mg Tablet 831,839 L.L
N04BD02 RAZYLECT 0.5 G Rasagiline mesylate - 0.5mg 0.5mg Tablet 2,036,369 L.L
D03AX RENEBO G β-sitosterol - 0.25% w/w 0.25% w/w Ointment 456,906 L.L
C05AE01 RECTOGESIC G Glyceryl trinitrate - 0.2% w/w 0.2% w/w Ointment 2,553,301 L.L
R05DB13 RAPICOD G Butamirate citrate - 0.15% 0.15% Syrup 296,989 L.L
D10AD04 ROACCUTANE B Isotretinoin - 0.05% 0.05% Gel 932,627 L.L
S01XA18 RESTASIS B Ciclosporin - 0.5mg/ml 0.05% Emulsion 4,100,063 L.L
S01XA18 RESTASIS B Ciclosporin - 0.5mg/ml 0.05% Emulsion 4,100,063 L.L
A02AC10 RENNIE B Magnesium carbonate - 80mg, Calcium carbonate - 680mg Tablet, chewable 240,548 L.L
C09BB07 RAMIPRIL/AMLODIPINE GENERICON G Ramipril - 2.5mg, Amlodipine - 5mg Capsule, hard 1,358,625 L.L
C09BB07 RAMIPRIL/AMLODIPINE GENERICON G Ramipril - 5mg, Amlodipine - 5mg Capsule, hard 1,358,625 L.L
C09BB07 RAMIPRIL/AMLODIPINE GENERICON G Ramipril - 10mg, Amlodipine - 5mg Capsule, hard 1,358,625 L.L
C09BB07 RAMIPRIL/AMLODIPINE GENERICON G Ramipril - 10mg, Amlodipine - 10mg Capsule, hard 1,358,625 L.L
R01AB08 RINOFLUIMUCIL B Acetylcysteine - 1%, Tuaminoheptane sulfate - 0.5%, Benzalkonium chloride - 0.0125% Solution 419,279 L.L
D10AD01 RETACNYL - 0.05 % G Tretinoin - 0.05% Cream 584,571 L.L
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