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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
N03AX18 VIMPAT B Lacosamide - 150mg 150mg Tablet, film coated 11,754,896 L.L
C09CA08 VOTUM B Olmesartan medoxomil - 20mg 20mg Tablet, film coated 954,128 L.L
N03AX18 VIMPAT B Lacosamide - 200mg 200mg Tablet, film coated 13,357,859 L.L
L01BC07 VIDAZA B Azacitidine - 100mg 100mg Injectable lyophilised powder L.L
C09CA08 VOTUM B Olmesartan medoxomil - 20mg 20mg Tablet, film coated 954,128 L.L
R03AC02 VENTOLIN B Salbutamol (sulfate) - 5mg/ml 5mg/ml Solution 403,153 L.L
N03AX18 VIMPAT B Lacosamide - 10mg/ml 10mg/ml Injectable solution 13,225,715 L.L
C09CA08 VOTUM B Olmesartan medoxomil - 40mg 40mg Tablet, film coated 1,032,071 L.L
N03AX18 VIMPAT B Lacosamide - 10mg/ml 10mg/ml Syrup 2,111,177 L.L
C09CA08 VOTUM B Olmesartan medoxomil - 40mg 40mg Tablet, film coated 1,032,071 L.L
L01EX03 VOTRIENT B Pazopanib HCl - 400mg 400mg Tablet, film coated 66,323,011 L.L
D11AF VERRUMAL B Fluorouracil - 0.5g/100g, Salicylic acid - 10g/100g Solution 529,474 L.L
G04CA53 VESOMNI B Tamsulosin HCl - 0.4mg, Solifenacin succinate - 6mg Tablet, modified release 4,491,122 L.L
L01EX03 VOTRIENT B Pazopanib HCl - 200mg 200mg Tablet, film coated 31,567,504 L.L
C10AX06 VASCEPA B Eicosapentaenoic acid (Ethyl ester) - 1g 1g Capsule 21,464,912 L.L
S01AD09 VIRGAN B Ganciclovir - 1.5mg/g 1.5mg/g Gel 804,962 L.L
B05AA07 VOLUVEN B Starch poly(O-2-Hydroxyethyl) - 6% 6% Injectable solution 987,724 L.L
C09DA08 VOTUM PLUS B Olmesartan medoxomil - 40mg, Hydrochlorothiazide - 25mg Tablet, film coated 933,971 L.L
C09DA08 VOTUM PLUS B Olmesartan medoxomil - 40mg, Hydrochlorothiazide - 12.5mg Tablet, film coated 933,971 L.L
C09DA08 VOTUM PLUS B Olmesartan medoxomil - 20mg, Hydrochlorothiazide - 25mg Tablet, film coated 900,374 L.L
C09DA08 VOTUM PLUS B Olmesartan medoxomil - 20mg, Hydrochlorothiazide - 12.5mg Tablet, film coated 900,374 L.L
M02AA15 VOLTAREN EMULGEL 12HRS B Diclofenac Diethylamine - 23.2mg/g 23.2mg/g Gel 1,169,143 L.L
M02AA15 VOLTAREN EMULGEL 12HRS B Diclofenac Diethylamine - 23.2mg/g 23.2mg/g Gel 717,612 L.L
S01LA09 VABYSMO B Faricimab - 6mg/0.05ml 6mg/0.05ml Injectable solution L.L
C09DB02 VOCADO B Olmesartan medoxomil - 20mg, Amlodipine besylate - 5mg Tablet, film coated 971,598 L.L
C09DB02 VOCADO B Olmesartan medoxomil - 40mg, Amlodipine besylate - 5mg Tablet, film coated 1,103,295 L.L
L01BC07 VIDAZA B Azacitidine - 100mg 100mg Injectable lyophilised powder 15,158,791 L.L
C09DB02 VOCADO B Olmesartan medoxomil - 40mg, Amlodipine besylate - 10mg Tablet, film coated 1,186,613 L.L
B01AB11 VESSEL DUE F TAB. B Sulodexide - 250LRU 250LSU Capsule, soft gelatin 2,792,505 L.L
J02AC03 VFEND B Voriconazole - 200mg 200mg Tablet, film coated 51,904,550 L.L
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