Paper
Objectives Jordan is moving forward toward enhancing medical tourism. Proton therapy (PT), an effective intervention for cancer treatment, is unavailable in some countries, often necessitating international travel to receive treatment. This study aims to evaluate the cost-benefit of establishing a PT facility in Jordan to address this gap. Our study is one of the first studies to evaluate the economic impact of medical tourism through establishing a PT facility, showing its potential to position Jordan as a regional hub for advanced medical care. Methods We conducted a financial benefit-cost analysis using an ex-ante analysis model. The analysis was conducted from two distinct perspectives: the healthcare payer perspective and the societal perspective. Model inputs were derived through a literature search and questionnaires completed by local experts. Deterministic sensitivity analysis (DSA) and probabilistic sensitivity analysis (PSA) were used to assess model robustness and explore key uncertainties. To overcome uncertainty in projected user numbers, two scenarios were created: a conservative scenario with average capacity, and an optimistic scenario based on maximum device utilization. Results The benefit-cost ratio (BCR) of establishing the facility was 1.24 from the societal perspective. This perspective showed a net present value (NPV) of 15 million Jordanian dinars (JOD), an internal rate of return (IRR) of 12%, and a payback period of seven years. From the public payer perspective, values were less favorable, but still positive, with a BCR of 1.08, an NPV of 5 million JOD, an IRR of 6%, and a payback period of nine years. Scenario analyses showed that, if the device is utilized to its maximum capacity, the benefit would increase reaching BCRs of 1.80 and 1.58 from the societal and healthcare payer perspectives, respectively. DSA and PSA proved the robustness of the model results. Conclusions The model shows that establishing a PT facility in Jordan is cost-effective, and is expected to generate substantial economic returns, making it a justifiable investment decision.