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Purpose – This research approaches to the new niche market of medical tourism to investigate how factors of cultural similarity influence the international distribution management. This study also estimates the interaction effects of distribution channel on the relationships of facility attributes and customers’ destination choice behavior. Research design, data, and methodology - We collected the sample of 881 potential customers from the more economically developed regions in China. Regression analysis is used to confirm the relationships in the research model. Results - The result shows that cultural similarity plays an important moderating role in the relationships of facility attributes and destination choice intention. For instance, power distance and masculinity interact with the distribution facility characteristics of medical quality and reputation to influence customers’ selection of the destination country. Individualism, powder distance, and masculinity play moderating roles when social environment affects destination choice intention. Especially, all the elements of cultural similarity moderate the relationships between travel cost and destination choice intention. This research also proves that depending on distribution channel, determinants of distribution facility are the critical predictors of intention to select the medical service outside of China. Conclusions - The study enables managers to develop the more effective strategies reflecting the interaction effects of cultural similarity and distribution channel on customers’ decision-making process.