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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
L01FG01 MVASI BioTech Bevacizumab - 400mg/16ml 400mg/16ml Injectable concentrate for solution 58,035,926 L.L
L01FG01 MVASI BioTech Bevacizumab - 100mg/4ml 100mg/4ml Injectable concentrate for solution 17,173,671 L.L
L01FX02 MYLOTARG BioTech Gemtuzumab Ozogamicin - 4.5mg 4.5mg Injectable powder 748,160,090 L.L
L03AX16 MOZOBIL B Plerixafor - 20mg/ml 20mg/ml Injectable solution 413,801,327 L.L
L04AA06 MYFORTIC B Mycophenolic acid (sodium) - 360mg 360mg Tablet, gastroresistant 20,324,991 L.L
L04AA06 MMF G Mycophenolate mofetil - 500mg 500mg Tablet, coated 4,087,969 L.L
L04AA06 MYORA G Mycophenolate mofetil - 500mg 500mg Tablet, film coated 3,643,157 L.L
L04AA42 MAYZENT B Siponimod - 0.25mg 0.25mg Tablet, film coated 15,102,158 L.L
L04AA42 MAYZENT B Siponimod - 0.25mg 0.25mg Tablet, film coated 124,258,444 L.L
L04AA42 MAYZENT B Siponimod - 2mg 2mg Tablet, film coated 124,258,444 L.L
L04AX03 METOJECT G Methotrexate disodium - 10mg/0.2ml 10mg/0.2ml Injectable solution 1,553,482 L.L
L04AX03 METOJECT G Methotrexate disodium - 15mg/0.3ml 15mg/0.3ml Injectable solution 1,968,729 L.L
L04AX03 METOJECT G Methotrexate disodium - 20mg/0.4ml 20mg/0.4ml Injectable solution 2,134,022 L.L
L04AX03 METOJECT G Methotrexate disodium - 25mg/0.5ml 25mg/0.5ml Injectable solution 2,582,865 L.L
L04AX07 MAROVAREX G Dimethyl Fumarate - 120mg 120mg Capsule, hard, gastro-resistant 9,838,676 L.L
L04AX07 MAROVAREX G Dimethyl Fumarate - 240mg Capsule, hard, gastro-resistant 60,848,734 L.L
M01AC56 MOBITIL G Meloxicam - 15mg, Beta-cyclodextrine - 75mg Tablet, film coated 212,327 L.L
M03BA03 METOFLEX G Methocarbamol - 750mg 750mg Tablet 2,941,671 L.L
M03BA53 METHOFEN PLATINUM G Ibuprofen - 200mg, Methocarbamol - 500mg Tablet 668,082 L.L
M03BC51 MUSCEROL 2 G Paracetamol - 450mg, Orphenadrine (citrate) - 35mg Tablet, scored 177,899 L.L
M03BC51 MUSCEROL EXTRA G Caffeine - 15mg, Paracetamol - 450mg, Orphenadrine citrate - 35mg Tablet, scored 267,489 L.L
M03BC51 MUSCEROL 3 G Paracetamol - 450mg, Orphenadrine citrate - 35mg, Ibuprofen - 200mg Tablet, film coated 593,850 L.L
M03BX04 MYDOCALM B Tolperisone - 150mg 150mg Tablet, film coated 839,902 L.L
M05BA04 MARVIL 70 G Alendronate (monosodium trihydrate) - 70mg 70mg Tablet, coated 1,173,175 L.L
M05BA07 MADRONATE G Risedronate sodium - 35mg 35mg Tablet, film coated 724,907 L.L
N01BB03 MEDICAINE 3% SANS VASOCONSTRICTEUR G Mepivacaine HCl - 3% 3% Injectable solution 954,128 L.L
N01BB53 MEDICAINE 2% WITH ADRENALINE G Mepivacaine HCl - 36mg/1.8ml, Epinephrine (tartrate) - 0.032mg/1.8ml Injectable solution 1,652,926 L.L
N02AA01 MST CONTINUS B Morphine sulfate - 10mg 10mg Tablet, film coated, prolonged release 972,942 L.L
N02AA01 MST CONTINUS B Morphine sulfate - 30mg 30mg Tablet, film coated, prolonged release 2,289,908 L.L
N02AA01 MST CONTINUS B Morphine sulfate - 60mg 60mg Tablet, film coated, prolonged release 3,839,358 L.L
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