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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
J05AF07 TENOFOVIR DISOPROXIL BIOGARAN G Tenofovir disoproxil - 245mg 245mg Tablet, film coated 9,747,613 L.L
J05AF07 TENOREAD G Tenofovir disoproxil fumarate - 300mg 300mg Tablet, film coated 7,129,777 L.L
J05AF07 TENVOR G Tenofovir disoproxil fumarate - 300mg 300mg Tablet, film coated 3,753,352 L.L
J05AH02 TAMIFLU B Oseltamivir (phosphate) - 75mg 75mg Capsule 1,464,788 L.L
J05AH02 TAMIFLU B Oseltamivir (phosphate) - 75mg 75mg Capsule 1,464,788 L.L
J05AR03 TRUVADA B Emtricitabine - 200mg, Tenofovir disoproxil - 245mg Tablet, film coated 21,319,383 L.L
J05AR12 TELADINE G Lamivudine - 300mg, Tenofovir disoproxil fumarate - 300mg Tablet 17,454,739 L.L
J05AR13 TRIUMEQ B Dolutegravir - 50mg, Abacavir sulfate - 600mg, Lamivudine - 300mg Tablet, film coated 74,756,237 L.L
J05AX12 TIVICAY B Dolutegravir - 50mg 50mg Tablet, film coated 54,508,037 L.L
J06BB02 TETAGAM P BioHuman Human Tetanus Immunoglobulin - 250IU/ml 250IU/ml Injectable solution 3,075,475 L.L
J06BB02 TETANUS GAMMA BioHuman Human Tetanus Immunoglobulin - 250IU/ml 250IU/ml Injectable solution 3,077,399 L.L
J07AP03 TYPHIM VI B Salmonella typhi polysaccharides - 0.025mg/0.5ml 0.025mg/0.5ml Injectable solution 1,118,077 L.L
J07AP03 TYPHIBEV TYPHOID CONJUGATED VACCINE (MONOVALENT) B Salmonella typhi polysaccharides Vi purified - 25mcg of Vi-PS2/0.5ml Injectable suspension 4,020,777 L.L
J07CA02 TETRAXIM (Vaccin Diphterique, tetanique, coquelucheux acellulaire et Poliomyelitique inactivé adsorbé) B Diphteria toxoid purified - ?30IU, Tetanus toxoid purified - ?40IU, Poliomyelitis virus type 1 inactivated - 40D.U., Poliomyelitis virus type 2 inactivated - 8D.U., Poliomyelitis virus type 3 inactivated - 32D.U., Bordetella Pertussis Antigens: toxoid - 25mcg, Bordetella Pertussis Antigens: filamentous haemagglutinin - 25mcg Injectable suspension 1,628,737 L.L
L01AC01 TEPADINA G Thiotepa - 100mg 100mg Injectable powder for concentrate for solution 98,197,306 L.L
L01AX03 TEMODAL B Temozolomide - 250mg 250mg Capsule 18,516,505 L.L
L01AX03 TEGOZOL G Temozolomide - 250mg 250mg Capsule 13,397,927 L.L
L01AX03 TEMOZOLOMIDE ACCORD G Temozolomide - 250mg 250mg Capsule, hard 13,397,927 L.L
L01AX03 TEMOZOLOMIDE GP PHARM G Temozolomide - 250mg 250mg Capsule, hard 12,058,004 L.L
L01AX03 TEMODAL B Temozolomide - 100mg 100mg Capsule 7,731,224 L.L
L01AX03 TEGOZOL G Temozolomide - 100mg 100mg Capsule 5,005,813 L.L
L01AX03 TEMOZOLOMIDE ACCORD G Temozolomide - 100mg 100mg Capsule, hard 5,590,385 L.L
L01AX03 TEMOZOLOMIDE GP PHARM G Temozolomide - 100mg 100mg Capsule, hard 4,511,279 L.L
L01AX03 TEMODAL B Temozolomide - 20mg 20mg Capsule 1,612,611 L.L
L01AX03 TEMOZOLOMIDE ACCORD G Temozolomide - 20mg 20mg Capsule, hard 1,153,017 L.L
L01AX03 TEMOZOLOMIDE GP PHARM G Temozolomide - 20mg 20mg Capsule, hard 920,532 L.L
L01AX03 TEGOZOL G Temozolomide - 20mg 100mg Capsule 967,567 L.L
L01AX03 TEMOZOLOMIDE ACCORD G Temozolomide - 5mg 5mg Capsule, hard 1,153,017 L.L
L01AX03 TEMOZOLOMIDE GP PHARM G Temozolomide - 5mg 5mg Capsule, hard 1,153,017 L.L
L01CD02 TAXOTERE B Docetaxel (trihydrated) - 80mg/4ml 80mg/4ml Injectable concentrated solution+diluent 24,150,868 L.L
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