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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
J06BB01 RHESONATIV BioHuman Human anti-D (rh) immunoglobulin - 625IU/ml 625IU/ml Injectable solution 12,281,758 L.L
A10AD06 RYZODEG BioTech Insulin degludec - 70%, Insulin aspart - 30% 100IU/ml Injectable solution 7,058,661 L.L
V03AB35 RELANCIUM G Sugammadex - 100mg/ml 100mg/ml Injectable solution 45,660,028 L.L
N01BB09 ROPIVACAINA MOLTENI G Ropivacaine HCl - 75mg/10ml 7.5mg/ml Injectable solution 2,332,911 L.L
N01BB09 ROPIVACAINE B. BRAUN G Ropivacaine HCl - 75mg/10ml 7.5mg/ml Injectable solution 4,831,114 L.L
C10AX13 REPATHA BioTech Evolocumab - 140mg/1ml Injectable solution 44,151,793 L.L
L03AB07 REBIF BioTech Interferon beta-1a - 44mcg/0.5ml 12MIU Injectable solution 82,479,505 L.L
L03AB07 RECIGEN 44 BioTech Interferon beta-1a - 44mcg/0.5ml 44mcg/0.5ml Injectable solution 15,147,973 L.L
L03AX16 REVIXIL 20 G Plerixafor - 20mg/ml 20mg/ml Injectable solution 248,280,900 L.L
B05BB01 RINGER'S INJECTION USP G Calcium chloride, 2H2O - 0.033%, Potassium chloride - 0.03%, Sodium chloride - 0.86% Injectable solution 199,957 L.L
B05BB01 RINGER'S INJECTION, USP G Calcium chloride, 2H2O - 0.33g/l, Potassium chloride - 0.3g/l, Sodium chloride - 8.6g/l Injectable solution 189,615 L.L
L03AB07 RECIGEN 44 BioTech Interferon beta-1a - 44mcg/0.5ml 44mcg/0.5ml Injectable solution L.L
H02AB02 RADOLINE G Dexamethasone sodium phosphate - 8mg/2ml 8mg/2ml Injectable solution 3,711,565 L.L
B05BB01 RINGER INJECTION G Sodium chloride - 0.86g/100ml, Calcium Chloride Dihydrate - 0.033g/100ml, Potassium chloride - 0.03g/100ml Injectable solution 204,554 L.L
B05BB01 RINGER'S INJECTION USP G Calcium chloride, 2H2O - 0.033%, Potassium chloride - 0.03%, Sodium chloride - 0.86% Injectable solution 129,934 L.L
B05BB01 RINGER'S INJECTION USP G Calcium chloride, 2H2O - 0.033%, Potassium chloride - 0.03%, Sodium chloride - 0.86% Injectable solution 205,933 L.L
B05BB01 RINGER'S INJECTION USP G Calcium chloride, 2H2O - 0.033%, Potassium chloride - 0.03%, Sodium chloride - 0.86% Injectable solution 224,565 L.L
B05BB01 RINGER'S INJECTION, USP G Calcium chloride, 2H2O - 0.33g/l, Potassium chloride - 0.3g/l, Sodium chloride - 8.6g/l Injectable solution 204,554 L.L
B05BB01 RINGER'S INJECTION, USP G Calcium chloride, 2H2O - 0.33g/l, Potassium chloride - 0.3g/l, Sodium chloride - 8.6g/l Injectable solution 154,450 L.L
B05BB01 R-SOL G Calcium chloride, 2H2O - 0.033%, Potassium chloride - 0.03%, Sodium chloride - 0.86% Injectable solution 205,933 L.L
L04AB02 REMSIMA SC BioTech Infliximab - 120mg/ml 120mg/ml Injectable solution 70,073,519 L.L
L04AB02 REMSIMA SC BioTech Infliximab - 120mg/ml 120mg/ml Injectable solution 125,560,051 L.L
L04AB02 REMSIMA SC BioTech Infliximab - 120mg/ml 120mg/ml Injectable solution 36,881,038 L.L
L04AB02 REMSIMA SC BioTech Infliximab - 120mg/ml 120mg/ml Injectable solution 125,560,051 L.L
L04AB02 REMSIMA SC BioTech Infliximab - 120mg/ml 120mg/ml Injectable solution 70,073,519 L.L
L04AB02 REMSIMA SC BioTech Infliximab - 120mg/ml 120mg/ml Injectable solution 36,881,038 L.L
L03AB07 REBIF BioTech Interferon beta-1a - 44mcg/0.5ml 12MIU Injectable solution L.L
J07BH01 ROTASIIL, ROTAVIRUS VACCINE, LIVE ATTENUATED (ORAL LIQUID) BioTech Rotavirus bovine-human , live attenuated - Liquid 2,822,069 L.L
C05AE01 RECTOGESIC G Glyceryl trinitrate - 0.2% w/w 0.2% w/w Ointment 2,553,301 L.L
D03AX RENEBO G ?-sitosterol - 0.25% w/w 0.25% w/w Ointment 456,906 L.L
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