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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
A04AA05 PALONAN G Palonosetron HCl - 250mcg/5ml 250mcg/5ml Injectable solution 2,194,495 L.L
G03GA06 PUREGON BioHuman Follitropin beta - 300IU/0.36ml 300IU/0.36ml Injectable solution 12,929,605 L.L
G03GA06 PUREGON BioHuman Follitropin beta - 300IU/0.36ml 300IU/0.36ml Injectable solution 12,929,605 L.L
G03GA06 PUREGON BioHuman Follitropin beta - 600IU/0.72ml 600IU/0.72ml Injectable solution 24,121,923 L.L
G03GA06 PUREGON BioHuman Follitropin beta - 600IU/0.72ml 600IU/0.72ml Injectable solution 24,121,923 L.L
N03AB02 PHENTOLEP INJECTION G Phenytoin (sodium) - 250mg/5ml 250mg/5ml Injectable solution 1,447,318 L.L
G03GA30 PERGOVERIS BioHuman Follitropin alfa - 150IU, Lutropin Alfa - 75IU Injectable powder for solution+diluent 6,523,011 L.L
J01CE01 PENICILLINE G PANPHARMA G Benzylpenicillin (sodium) - 1,000,000IU 1,000,000IU Injectable powder for solution 2,858,353 L.L
J01CR05 PIPERACILINA/TAZOBACTAM SALA G Piperacillin (sodium) - 4g, Tazobactam (sodium) - 0.5g Injectable powder for solution 913,813 L.L
J01CR05 PIPERACILLIN/TAZOBACTAM PANPHARMA G Piperacillin (sodium) - 4g, Tazobactam (sodium) - 0.5g Injectable powder for solution 7,461,939 L.L
J01CR05 PIPERACILLIN/TAZOBACTAM SANDOZ G Piperacillin (sodium) - 4g, Tazobactam (sodium) - 0.5g Injectable powder for solution 913,813 L.L
J01CR05 PIPERACILLIN/TAZOBACTAM STRAGEN G Piperacillin (sodium) - 4g, Tazobactam (sodium) - 0.5g Injectable powder for solution 897,687 L.L
J01CR05 PIPERACILLIN/TAZOBACTAM STRAGEN G Piperacillin (sodium) - 4g, Tazobactam (sodium) - 0.5g Injectable powder for solution 7,820,986 L.L
J01CR05 PIPERACILLINE/ TAZOBACTAM ARROW G Piperacillin (sodium) - 4g, Tazobactam (sodium) - 500mg Injectable powder for solution 7,378,682 L.L
J01CR05 PIPTAZ-ORBUCELL G Piperacillin (sodium) - 4g, Tazobactam (sodium) - 0.5g Injectable powder for solution 1,087,873 L.L
J01CR05 PRIZMA G Piperacillin (sodium) - 4g, Tazobactam (sodium) - 0.5g Injectable powder for solution 913,813 L.L
A02BC02 PANTONIX-JULPHAR G Pantoprazole - 40mg 40mg Injectable powder for solution 260,705 L.L
A02BC02 PANTOPRAZOL SALA G Pantoprazole (sodium) - 40mg 40mg Injectable powder for solution 503,941 L.L
L01BA04 PEMETREXED ACCORD G Pemetrexed (disodium) - 500mg 500mg Injectable powder for concentrate for solution 20,000,292 L.L
L01BA04 PEMITRA G Pemetrexed (disodium) - 500mg 500mg Injectable powder for concentrate for solution 47,161,032 L.L
L01FX14 POLIVY BioHuman Polatuzumab vedotin - 140mg 140mg Injectable powder for concentrate for solution L.L
L01FX14 POLIVY BioHuman Polatuzumab vedotin - 140mg 140mg Injectable powder for concentrate for solution 1,146,496,418 L.L
L01BA04 PEMETREXED NEAPOLIS G Pemetrexed (disodium) - 500mg Injectable powder L.L
L01BA04 PEMETREXED NEAPOLIS G Pemetrexed (disodium) - 500mg Injectable powder 41,289,202 L.L
J07BD52 PRIORIX B Rubella virus live attenuated - ?10³ CCID50, Mumps virus live attenuated - ?103.7 CCID50, Measles virus live attenuated - ?10³ CCID50 Injectable lyophilised powder for solution+diluent 1,142,266 L.L
L01BA04 PEMETREXED GP PHARM G Pemetrexed (disodium) - 500mg 500mg Injectable lyophilised powder 46,641,484 L.L
N01AX10 PROPOFOL-LIPURO B Propofol - 10mg/ml 1% Injectable emulsion 1,411,035 L.L
N01AX10 PROPOFOL 1% MCT/LCT FRESENIUS G Propofol - 1% 1% Injectable emulsion 847,965 L.L
B05BA10 PERIOLIMEL N4E B Olive oil + Soja oil - 45.00g, Alanine - 5.50g, Arginine - 3.72g, Aspartic Acid - 1.10g, Glutamic Acid - 1.90g, Glycine - 2.63g, Histidine - 2.26g, Isoleucine - 1.90g, Leucine - 2.63g, Lysine - 2.99g, Methionine - 1.90g, Phenylalanine - 2.63g, Proline - 2.26g, Serine - 1.50g, Threonine - 1.90g, Tryptophan - 0.64g, Tyrosine - 0.10g, Valine - 2.43g, Sodium acetate, 3H2O - 1.73g, Sodium glycerophosphate, H2O - 2.87g, Potassium chloride - 1.79g, Magnesium chloride, 6H2O - 0.67g, Calcium chloride 2H2O - 0.44g, Glucose monohydrate - 123.75g Injectable emulsion 5,288,020 L.L
J07CA06 PENTAXIM B Poliomyelitis virus type 3 inactivated(Prefilled syringe) - 32D.U., Poliomyelitis virus type 2 inactivated(Prefilled syringe) - 8D.U., Poliomyelitis virus type 1 inactivated(Prefilled syringe) - 40D.U., Bordetella pertussis antigen (Prefilled syringe) - toxoid 25mcg+filamentous haemaglutinin 25mcg, Tetanus toxoid (Prefilled syringe) - ?40IU, Diphtheria toxoid (Prefilled syringe) - ?30IU, H. Influenza type b polysaccharide(Vial) - 10mcg Injectable dry powder+suspension 2,558,676 L.L
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