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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
L01EA05 ICLUSIG B Ponatinib - 15mg 15mg Tablet, film coated 103,555,839 L.L
L01EA05 ICLUSIG B Ponatinib - 45mg 45mg Tablet, film coated 207,092,651 L.L
N05CF04 INDUCTAL G Eszopiclone - 2mg 2mg Tablet, film coated 1,411,035 L.L
N05CF04 INDUCTAL G Eszopiclone - 3mg 3mg Tablet, film coated 1,693,242 L.L
C09CA04 IBECARD 150- IPS G Irbesartan - 150mg 150mg Tablet, film coated 564,414 L.L
C09CA04 IRBAVEL 150 G Irbesartan - 150mg 150mg Tablet, film coated 564,414 L.L
L01EF01 IBRANCE B Palbociclib - 75mg 75mg Tablet, film coated 172,164,216 L.L
C09CA04 IBECARD 300- IPS G Irbesartan - 300mg 300mg Tablet, film coated 564,414 L.L
C09CA04 IRBAVEL 300 G Irbesartan - 300mg 300mg Tablet, film coated 564,414 L.L
L01EF01 IBRANCE B Palbociclib - 100mg 100mg Tablet, film coated 172,164,216 L.L
L01EF01 IBRANCE B Palbociclib - 125mg 125mg Tablet, film coated 172,164,216 L.L
L01EL01 IMBRUVICA B Ibrutinib - 420mg 420mg Tablet, film coated L.L
J01MA12 ILFLOX G Levofloxacin - 500mg 500mg Tablet, film coated 587,259 L.L
L04AA06 IMUNOCELL G Mycophenolate mofetil - 500mg 500mg Tablet, film coated 3,791,428 L.L
L01EK01 INLYTA B Axitinib - 5mg 5mg Tablet, film coated 184,486,511 L.L
L01EK01 INLYTA B Axitinib - 1mg 1mg Tablet, film coated 57,595,789 L.L
L01EL01 IMBRUVICA B Ibrutinib - 140mg 140mg Tablet, film coated 194,761,420 L.L
L01EL01 IMBRUVICA B Ibrutinib - 420mg 420mg Tablet, film coated 584,283,050 L.L
M01AE51 IBUGESIC COLD AND SINUS G Ibuprofen - 200mg, Pseudoephedrine HCl - 30mg Tablet, film coated 154,542 L.L
C09DA04 IBECARD PLUS 150/12.5 G Irbesartan - 150mg, Hydrochlorothiazide - 12.5mg Tablet, film coated 559,294 L.L
C09DA04 IRBAVEL PLUS 150/12.5 G Irbesartan - 150mg, Hydrochlorothiazide - 12.5mg Tablet, film coated 559,294 L.L
C09DA04 IBECARD PLUS 300/12.5 G Irbesartan - 300mg, Hydrochlorothiazide - 12.5mg Tablet, film coated 559,294 L.L
C09DA04 IRBAVEL PLUS 300/12.5 G Irbesartan - 300mg, Hydrochlorothiazide - 12.5mg Tablet, film coated 559,294 L.L
C09DA04 IBECARD PLUS 300/25 G Irbesartan - 300mg, Hydrochlorothiazide - 25mg Tablet, film coated 624,567 L.L
C09DA04 IRBAVEL PLUS 300/25 G Irbesartan - 300mg, Hydrochlorothiazide - 25mg Tablet, film coated 624,567 L.L
C08DA01 ISOPTIN B Verapamil (HCl) - 80mg 80mg Tablet, film coated 397,704 L.L
A10BD09 INCRESYNC B Pioglitazone - 15mg, Alogliptin - 25mg Tablet, film coated 3,897,143 L.L
A10BD09 INCRESYNC B Pioglitazone - 30mg, Alogliptin - 25mg Tablet, film coated 3,897,143 L.L
A10BD11 INAGLIMET G Metformin - 1000mg, Linagliptin - 2.5mg Tablet, film coated 1,670,844 L.L
A10BD11 INAGLIMET G Metformin - 850mg, Linagliptin - 2.5mg Tablet, film coated 1,670,844 L.L
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