Lebanon’s Drug Shortage Between Structural and Circumstantial

Abstract

This study explores the 2019 drug shortage in Lebanon by examining its structural and circumstantial causes through a qualitative, multi-source methodology. While international organization reports and academic literature attribute the crisis to economic collapse, foreign currency shortages, hoarding, and the COVID-19 pandemic, this research highlights deeper systemic issues, notably monopolistic practices by pharmaceutical importers. Termed the "drug cartel," these entities control a significant share of the Lebanese drug market and have long operated with political backing. The study evaluates the impact of the Ministry of Public Health’s Resolution 119/2020 and its amendments, which introduced a formula-based pricing system designed to increase fairness and transparency. Using case studies of five drugs, the research traces their pricing and supply chains, comparing local public prices to those in their countries of origin. Despite official pricing reforms, importers consistently refused to disclose procurement prices, pointing to ongoing opacity. While the reforms led to price reductions, questions remain about the motives behind these changes and whether they reflect regulatory success or strategic pricing by manufacturers to maintain market dominance. Ultimately, this project calls for further research into price transparency and cartel influence to better understand and address Lebanon’s pharmaceutical vulnerabilities.