Ask three sources how much money medical tourism brings into Costa Rica and you can get three different answers. Nobody giving them is lying. They are counting different things, in different years, with different rules about who counts. The gaps matter well beyond tourism, because every health-sector claim, from a clinic’s patient numbers to a supplier’s product quality, rests on the same question: who measured it, and can you see how?
Costa Rica makes a useful case study. It is a small country with a visible private health sector, a long record of attracting foreign patients and a habit of publishing impressive totals. Looking at where those totals come from shows how to read any number in this field.
The figures on the table
The most quoted figure traces back to the Central Bank of Costa Rica. According to the trade publication IMTJ, central bank data put medical tourism income at US$465 million in 2019. The same report put income for the first two quarters of 2022 at US$56 million, which read as a recovery from the collapse in travel during the pandemic.
Older numbers show how loose the counting has been. The trade group Promed reported 48,253 medical tourists for 2011 and an average spend of about $7,000 each. Multiply the two and you reach roughly $338 million. IMTJ questioned that arithmetic at the time, pointing out that $7,000 is more than most procedures cost, which suggests the same patient was being counted by several businesses at once.
A third number comes from a market-research firm. IMARC Group puts the Costa Rican medical tourism market at USD 289 million for 2024. That is well below the central bank’s 2019 total, even though tourism overall has recovered since. The public summary of the report does not explain the gap, so a reader has to treat the two figures as answers to different questions.
Why serious estimates disagree
The first reason is definition. A visitor who has a dental implant fitted and spends a week at the beach is a medical tourist in some studies and an ordinary tourist in others. Some counts include only the procedure fee. Others add flights, hotels, recovery stays and the relatives who travelled along.
The second reason is method. Several of the early figures depended on surveys, reports from providers and extrapolation, with no single registry of foreign patients behind them. An official involved in a PROCOMER effort to improve the data said, as the Tico Times reported, that reliable statistics for the sector had been missing. When the raw data is thin, every estimate leans on assumptions, and the assumptions differ from one author to the next.
The third reason is timing. A 2019 figure, a 2022 half-year figure and a 2024 market-size estimate describe three very different economic situations. Comparing them as if they were a single time series is the most common way to misread this sector.
None of this makes the numbers useless. It means each one needs a label: who counted, which year, what was included. A figure without that label is a rumor with a decimal point.
Who comes, and why they come
The composition of the visitor base is better documented than the dollar totals. Data from the Costa Rican Chamber of Health, reported by IMTJ, shows that more than 80 percent of medical visitors come from the United States and about 10 percent from Canada. That concentration shapes what the sector has to deliver. A patient from Ohio or Ontario arrives expecting paperwork, itemized invoices and records that make sense back home.
A PROCOMER study, summarized by the Tico Times, found that visitors were drawn by lower prices, the quality of the professionals, the range of services from preventive care to cosmetic and wellness treatments, and the country’s political and economic stability. A 2016 Medical Tourism Index ranked Costa Rica fourth in the Americas and fourteenth worldwide, behind Canada, Colombia and Panama in the regional table.
Notice what those drivers have in common. Price is the only one that can be checked on a quote. The rest are trust, and trust in a health market is built on documents that a stranger can inspect.
The supply chain nobody counts
Behind every clinic and laboratory sits a supply chain that rarely appears in tourism statistics. Surgical consumables, dental materials, diagnostic reagents and laboratory standards all arrive through customs, travel in conditions nobody on the receiving end observed and sit in storage in a climate where heat and humidity are the default. A delay at the border or a warm afternoon in a delivery van can change what a product is worth by the time it reaches the shelf.
That is the commercial argument for local suppliers. Peptides Costa Rica, a research-materials supplier, says it serves only customers inside the country, and argues that operating locally avoids the shipping delays, customs problems and surprise import fees that come with ordering from abroad. It is a plain business claim, and a reasonable one to test.
The same homepage FAQ is candid about limits. It states that the products are supplied for laboratory and research purposes, that they are not registered with Costa Rica’s Ministerio de Salud as pharmaceutical products, and that the company gives no dosing guidance or medical advice. A supplier that says what it is not is easier to deal with than one that lets buyers guess.
What “documentation” should actually mean
Every supplier says it has documentation. Few buyers define the word. A useful definition has five parts.
- A batch or lot identifier that appears on the product and on the paperwork, so the two can be matched.
- A named source for any test result, ideally one that is independent of the seller.
- A statement of storage conditions, from production to delivery, because humidity and heat are part of the product’s history in a tropical country.
- An honest statement of regulatory status, including what the product is not approved or registered for.
- A person or company a buyer can contact when something does not match.
The public FAQ is one place to see how a local research supplier handles ordering and documentation in practice. How a local research supplier handles ordering and documentation is spelled out there: availability is confirmed before payment, the total is given up front, and certificates of analysis are offered on request. Those are policies, and a policy proves nothing until a buyer uses it. The test is to ask for a certificate, read it and check that its batch number matches the product in hand.
A rule for reading any health-sector number
The Costa Rican example reduces to a short set of questions that work for any industry statistic, from medical tourism revenue to market-size forecasts.
- Who counted, and do they have a reason to prefer a bigger or smaller total?
- Which year does the figure describe, and what happened in the economy that year?
- What exactly is included: the procedure, the trip, the companions, the follow-up care?
- Was the figure measured from records or extrapolated from a survey?
- Could the same person or payment be counted twice?
Names help as well as numbers. A small supplier that says who founded it and why is easier to question than an anonymous storefront. The founders’ own account of Peptides Costa Rica describes a business that began when acquaintances working at a research laboratory complained about delays caused by relying on international suppliers. That is a founding story, not evidence of quality. It does give a buyer a person to ask and a claim to check, and checking is the habit that separates a market from a marketing campaign.
The next time a headline gives a single dollar figure for a health industry, write down three things: the source, the year and the definition. If you cannot fill in all three, you are looking at an estimate. Treat it that way until someone shows the working.
