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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
R06AA59 CARIBAN B Pyridoxine HCl - 10mg, Doxylamine succinate - 10mg Capsule, hard, modified release 1,701,305 L.L
C09CA03 DIOVAN B Valsartan - 80mg 80mg Tablet, film coated 602,041 L.L
J01FF01 DALACIN-C B Clindamycin HCl - 150mg 150mg Capsule 287,582 L.L
L01EA03 TASIGNA B Nilotinib - 150mg 150mg Capsule 323,961,910 L.L
L02BB05 ERLEADA B Apalutamide - 60mg 60mg Tablet, film coated 264,151,186 L.L
V03AE03 FOSRENOL B Lanthanum Carbonate - 500mg 500mg Tablet, chewable 18,751,847 L.L
A10BK01 FORXIGA B Dapagliflozin - 10mg 10mg Tablet, film coated 2,927,964 L.L
J01FF01 DALACIN-C B Clindamycin HCl - 300mg 300mg Capsule 478,408 L.L
L01EA04 BOSULIF B Bosutinib - 100mg 100mg Tablet, film coated 35,663,747 L.L
L02BB05 ERLEADA B Apalutamide - 60mg 60mg Tablet, film coated 264,151,186 L.L
V03AE03 FOSRENOL B Lanthanum Carbonate - 750mg 750mg Tablet, chewable 24,138,283 L.L
A07EA06 CORTIMENT MMX B Budesonide - 9mg 9mg Tablet, prolonged release 8,996,996 L.L
L01EA04 BOSULIF B Bosutinib - 400mg 400mg Tablet, film coated 123,564,667 L.L
L02BB06 NUBEQA B Darolutamide - 300mg Tablet, film coated 470,558,010 L.L
N03AX11 TOPAMAX B Topiramate - 50mg 50mg Tablet, film coated 1,914,976 L.L
A07EC02 ASACOL B Mesalazine - 400mg 400mg Tablet, enteric coated 5,895,437 L.L
D07CC01 FUCICORT B Fusidic acid - 20mg/g, Betamethasone (valerate) - 1mg/g Cream 376,276 L.L
J01CR02 AUGMENTIN B Amoxicillin (trihydrate) - 250mg, Clavulanic Acid (potassium) - 125mg 375mg Tablet, film coated 490,503 L.L
L01EA04 BOSULIF B Bosutinib - 500mg 500mg Tablet, film coated 154,453,246 L.L
L02BG03 ARIMIDEX B Anastrozole - 1mg 1mg Tablet, film coated 3,202,377 L.L
R06AB54 ALERGICAL EXPECTORANT B Chlorpheniramine maleate - 50mg/100ml, Guaifenesin - 2000mg/100ml, Dihydroxypropyltheophylline - 500mg/100ml, Paracetamol - 2000mg/100ml Syrup 485,127 L.L
V03AF01 UROMITEXAN B Mesna - 400mg/4ml 400mg/4ml Injectable solution 2,632,587 L.L
A07EC02 SALOFALK B Mesalazine - 500mg 500mg Tablet, enteric coated 2,874,479 L.L
D07CC01 FUCICORT B Fusidic acid - 20mg/g, Betamethasone (valerate) - 1mg/g Cream 501,253 L.L
G04BE03 VIAGRA B Sildenafil (citrate) - 100mg 100mg Tablet, film coated 2,089,675 L.L
L01EA05 ICLUSIG B Ponatinib - 15mg 15mg Tablet, film coated 103,555,839 L.L
M01AB16 AIRTAL 100MG 20 B Aceclofenac - 100mg 100mg Tablet, film coated 471,689 L.L
A10BK03 JARDIANCE B Empagliflozin - 25mg 25mg Tablet, film coated 3,282,953 L.L
C03CA01 LASIX B Furosemide - 500mg 500mg Tablet 1,454,038 L.L
J01CR02 AUGMENTIN B Amoxicillin (trihydrate) - 500mg, Clavulanic Acid (potassium) - 125mg 625mg Tablet 639,958 L.L
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