The impact of socioeconomic crisis on cancer patient outcomes in Lebanon, 2018–2020
Publication: Journal of Comparative Effectiveness Research
Abstract
Aim: The goal of this study was to assess the impact of economic and social crisis on access to cancer care in Lebanon. Materials & methods: A cancer Drug Access Program in Lebanon was launched, covering 80–90% of treatment costs. The program included three drugs for breast cancer, renal cancer, and lung cancer. A longitudinal follow-up of patients was conducted. The Multidimensional Poverty Measure (MPI) was used by year (2019 or 2021), i.e., before and after the onset of the economic crisis. Results: A total of 613 cancer patients were included in 50 hospitals. Mean patient age was 58.5 years (standard deviation = 12.3). The proportion of cancer types was 79.3% breast, 10.6% renal, and 7.3% lung cancer. Treatment with palbociclib (hazard ration [HR]: 1.64; 95% confidence interval [CI]: 1.53–1.76, p < 0.0004), enrollment prior to 1 January 2019 (HR: 1.24; 95% CI: 1.07–1.44, p = 0.004), treatment at a hospital with fewer than five physicians (HR: 1.11; 95% CI: 1.00–1.23, p = 0.04), and lower 2019 MPI (HR: 1.69; 95% CI: 1.30–2.20) were significant predictive factors associated with survival. Higher governorate-level MPI was associated with increased mortality (adjusted rate ratio per 0.1-unit, HR: 2.88; 95% CI: 0.95–8.77, p = 0.06). Conclusion: Economic crises have negative impacts on health outcomes, and we identified a change in survival pre/post crisis onset. This study argues strongly for coordinated efforts to mitigate the negative effects of poverty on health.
Plain language summary: How did the economic crisis in Lebanon impact the health of patients treated for cancer between 2018 and 2020?
What is this article about?
Since 2019, several events (an ongoing economic crisis, war in a neighboring country, severe wildfires, a massive explosion at a large port, the COVID-19 pandemic and political unrest) have negatively impacted Lebanon’s economy and made it difficult for patients to receive care. This study identified factors that impacted survival for cancer patients who began treatment before the start of Lebanon’s economic crisis in 2019 and those who started treatment once the crisis had begun.
What were the results?
This study found that patients who began cancer treatment before the start of the 2019 crisis were more likely to survive than patients who started treatment in 2019 or 2020. Other factors associated with being more likely to survive were treatment with a specific drug for breast cancer, treatment at a hospital with fewer than five physicians, and lower levels of poverty in 2019.
What do the results mean?
The results mean that factors unrelated to a cancer patients’ disease – when they started treatment, staffing at the hospital where they were treated, and their poverty level – can impact how likely they are to survive. These findings add to other data that show how poverty can negatively impact health. They also suggest that reducing poverty is important for improving survival in patients with cancer.
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© 2026 The authors. This work is licensed under the Attribution-NonCommercial-NoDerivatives 4.0 Unported License
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Received: 17 June 2025
Accepted: 17 December 2025
Published online: 21 January 2026
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The impact of socioeconomic crisis on cancer patient outcomes in Lebanon, 2018–2020. (2026) Journal of Comparative Effectiveness Research. DOI: 10.57264/cer-2025-0099
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