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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
D11AH05 DUPIXENT BioTech Dupilumab - 200mg 200mg Injectable solution 123,001,362 L.L
A03AA04 DUSPATALIN RETARD B Mebeverine HCl - 200mg 200mg Capsule 895,581 L.L
L01AX04 DACARBAZINE MEDAC G Dacarbazine - 200mg 200mg Injectable powder for solution 15,866,076 L.L
J04AB03 DIARENTIS B Rifamycin sodium - 200mg 200mg Tablet, extended release 1,100,671 L.L
N03AG01 DEPAKINE B Sodium Valproate - 200mg/3.47ml 200mg/3.47ml Syrup 442,124 L.L
C01CA04 DOPAMINE FRESENIUS G Dopamine HCl - 200mg/5ml 200mg/5ml Injectable concentrated solution 713,580 L.L
N03AG01 DEPAKINE B Sodium Valproate - 200mg/ml 200mg/ml Solution 360,150 L.L
B05CX01 DEXTROSE G Dextrose, H2O - 20g/100ml 20g/100ml Injectable solution 369,209 L.L
B05CX01 DEXTROSE G Dextrose, H2O - 20g/100ml 20g/100ml Injectable solution 807,874 L.L
B05XB02 DIPEPTIVEN B L-alanine-L-Glutamine - 20g/100ml 20g/100ml Injectable concentrated solution 2,940,456 L.L
A02BC01 DIGCAP G Omeprazole - 20mg 20mg Capsule 593,850 L.L
L01EA02 DALEUBIN G Dasatinib - 20mg 20mg Tablet, film coated 82,387,571 L.L
L01EA02 DASATINIB NEAPOLIS G Dasatinib - 20mg 20mg Tablet, film coated 103,165,573 L.L
G04BE08 DURALIS G Tadalafil - 20mg 20mg Tablet, film coated 1,204,979 L.L
G04BE08 DURALIS G Tadalafil - 20mg 20mg Tablet, film coated 624,567 L.L
N06AB05 DEPROX G Paroxetine (HCl) - 20mg 20mg Tablet 972,686 L.L
L01CD02 DOCETAXEL GP PHARM G Docetaxel - 40mg/ml 20mg/0.5ml Injectable concentrated solution+diluent 4,567,721 L.L
L01CD02 DOCETAXEL ACCORD G Docetaxel - 20mg/ml 20mg/1ml Injectable concentrate for solution 4,110,814 L.L
L01CD02 DOCETAXEL EBEWE G Docetaxel - 20mg/2ml 20mg/2ml Injectable solution 5,313,553 L.L
A01AB09 DAKTARIN ORAL B Miconazole nitrate - 20mg/g 20mg/g Gel 377,620 L.L
D01AC02 DAKTARIN B Miconazole nitrate - 20mg/g 20mg/g Cream 231,141 L.L
D06AX01 DERMICIN G Fusidic acid - 20mg/g 20mg/g Cream 175,339 L.L
M01AE01 DIMIDON G Ibuprofen - 20mg/ml 20mg/ml Suspension 483,783 L.L
S01EC03 DORZOLAMIDE BGR G Dorzolamide HCl - 20mg/ml 20mg/ml Drops solution 517,379 L.L
A11CC05 D-CURE G Vitamin D3 - 25,000IU 25,000IU Solution 467,657 L.L
V03AC03 DIFIRAX G Deferasirox - 250mg 250mg Tablet, dispersible 23,213,276 L.L
B02BX01 DICYNONE B Etamsylate - 250mg/2ml 250mg Injectable solution 482,439 L.L
C01CA07 DOBUTAMINE PANPHARMA G Dobutamine (HCl) - 250mg/20ml 250mg/20ml Injectable concentrated solution 2,701,123 L.L
N02AB03 DUROGESIC B Fentanyl - 4.2mg 25mcg/h Patch 1,509,135 L.L
M01AE17 DEXKEVITAE G Dexketoprofen (trometamol) - 25mg 25mg Tablet, film coated 486,471 L.L
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