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Jurisdictions
155FDA — United States
First regulator in the world to clear medicinal leeches as a medical device — Hirudo medicinalis cleared under K040187 (June 21 2004).
Health Canada — Canada
Regulates Hirudo medicinalis under the Medical Devices Regulations as a Class II device; mirrors FDA risk classification with bilingual labelling requirements.
COFEPRIS — Mexico
Mexico's federal health-risk authority — leech therapy regulated as a medical device under General Health Law, with traditional-medicine carve-outs at state level.
EMA — European Union
Centralised EU authority for medicinal products — leeches sit on the border between MDR-regulated device and HMPC traditional herbal medicine framework.
European Commission — European Union
EU executive body responsible for the Medical Device Regulation (MDR) — the legal instrument that frames how Member States CE-mark leech products.
MHRA — United Kingdom
Post-Brexit UK regulator — accepts EU CE marks during transition, with UKCA marking now phased in for Great Britain (Northern Ireland follows EU MDR via Windsor Framework).
BfArM — Germany
Germany classifies medicinal leeches as a finished medicinal product (Fertigarzneimittel) — uniquely strict among EU Member States and requires marketing authorisation via BfArM.
ANSM — France
Home regulator of Ricarimpex SAS — the world's only leech manufacturer simultaneously CE-marked and FDA-cleared, operating under ANSM oversight since 1845.
AIFA — Italy
Italian Medicines Agency — leech therapy supervised under MDR via the Ministero della Salute, with established complementary-medicine reimbursement in selected regions (Toscana, Emilia-Romagna).
AEMPS — Spain
Spanish medicines and devices agency — leech therapy regulated as a medical device with mandatory Spanish-language IFU and autonomous-community-level integration in some public health services.
Swissmedic — Switzerland
Switzerland's therapeutic-products regulator — applies MepV (Medical Devices Ordinance) closely harmonised with EU MDR, with bilateral recognition agreements covering CE-marked devices including leeches.
Läkemedelsverket — Sweden
Sweden's medical products agency — regulates leeches via the EU MDR and Patientsäkerhetslagen, with reimbursement limited to inpatient reconstructive indications under regional landsting protocols.
Fimea — Finland
Finland's medicines agency — regulates medical devices including leeches under EU MDR; oversight transferred from Valvira to Fimea for medical devices effective 1 January 2020.
FOPH / BAG — Switzerland
Swiss federal public-health authority — sets reimbursement scope under KLV including the historic 2017 decision to make hirudotherapy permanently reimbursable when delivered by FMH-credentialed physicians.
Roszdravnadzor — Russia
Russia's federal healthcare regulator — uniquely classifies medicinal leeches as a pharmaceutical drug under Federal Law No. 61-FZ, with a federally recognised hirudotherapy speciality and OMS coverage.
PMDA — Japan
Japan's medicines and devices regulator — leech therapy classified within the Kampo / traditional-medicine framework under MHLW oversight, with no PMDA-issued device approval to date.
NMPA — China
China's medical-products regulator — leeches (水蛭 / shui zhi) are codified in the Chinese Pharmacopoeia as Traditional Chinese Medicine (TCM) and regulated as a Chinese herbal medicine.
MFDS — South Korea
South Korea's drug-safety regulator (formerly KFDA) — leech therapy practised within the Korean Medicine (한의학 / Hanui) tradition; Hirudo medicinalis listed in the Korean Pharmacopoeia.
CDSCO — India
India's central drug regulator — leech therapy (Jalaukavacharana / जलौकावचारण) integrated into the official AYUSH system as part of Ayurveda Panchakarma practice.
TGA — Australia
Australia's therapeutic-goods regulator — medicinal leeches included in the Australian Register of Therapeutic Goods (ARTG) as Class IIa medical device with import permit oversight.
Medsafe — New Zealand
New Zealand's medicines and medical-devices regulator — operates under the Medicines Act 1981 with leech therapy regulated as a notified medical device and biosecurity-controlled import.
HSA — Singapore
Singapore's health sciences regulator — leech therapy supervised under the Health Products Act 2007 with separate licensing for TCM practitioners using leeches in clinical practice.
TFDA — Taiwan
Taiwan's food and drug administration — leech preparations regulated under the Pharmaceutical Affairs Act with traditional Chinese medicine practice formally licensed under the Ministry of Health and Welfare.
DOH-FDA — Philippines
Philippine FDA (under Department of Health) — leech therapy regulated as a medical device with parallel traditional and alternative medicine pathway under the PITAHC framework.
ANVISA — Brazil
Brazil's national health-surveillance agency — leech therapy regulated as a medical device with parallel coverage under the SUS Practices Integrativas e Complementares (PICS) policy.
INVIMA — Colombia
Colombia's national medicines and devices surveillance agency — leech therapy regulated as a medical device under Decreto 4725/2005 with TM/CAM oversight by the Ministerio de Salud.
DIGEMID — Peru
Peru's medicines, supplies and drugs directorate — leech therapy supervised under Ley General de Salud and complementary-medicine framework, with DIRESA-level enforcement.
Israeli MoH — Israel
Israel's Ministry of Health (Misrad HaBri'ut) — leech therapy regulated under the Pharmacists' Ordinance with Medical Devices Division oversight; significant clinical use in reconstructive and microsurgery services.
EDA — Egypt
Egypt's Egyptian Drug Authority (formed 2019, replacing the older CAPA / Central Administration of Pharmaceutical Affairs) — leech therapy regulated as a medical device with parallel traditional-medicine context.
SFDA — Saudi Arabia
Saudi Arabia's SFDA — leech therapy supervised under medical-device pathway, with Saudi Vision 2030 expansion of traditional/complementary medicine via NCCAM-KSA at the Ministry of Health.
SAHPRA — South Africa
South Africa's SAHPRA (created 2018, replacing the Medicines Control Council) — leech therapy regulated as a medical device under the Medicines and Related Substances Act; traditional-health practitioners under separate THP Council.
WHO — Global (United Nations specialised agency)
Global health authority — Hirudo medicinalis listed in the WHO Monographs on Selected Medicinal Plants (informational) and embedded in the Traditional Medicine Strategy 2014–2023 and 2025–2034 successor.
BASG — Austria
Austria's federal authority for safety in health care — applies EU MDR directly; leech-specific regulation has not been independently verified by ASH and is presumed to follow the general EU medical-device framework.
MEB / CBG — Netherlands
Dutch Medicines Evaluation Board — paired with IGJ (Health and Youth Care Inspectorate) for device oversight; leech-specific regulatory pathway in the Netherlands has not been independently verified by ASH.
DKMA — Denmark
Denmark's medicines agency — applies EU MDR for medical devices; leech-specific regulation has not been independently verified by ASH and is presumed to follow the general MDR framework.
DMP — Norway
Norway's medical products agency (formerly Statens legemiddelverk, rebranded DMP in 2024) — applies EU MDR via EEA Agreement; leech-specific regulation has not been independently verified by ASH.
Infarmed — Portugal
Portugal's national medicines and health products authority — applies EU MDR for medical devices; leech-specific regulation has not been independently verified by ASH.
FAMHP — Belgium
Belgium's federal agency for medicines and health products — applies EU MDR for devices; leech-specific regulation has not been independently verified by ASH.
URPL — Poland
Poland's Office for Registration of Medicinal Products, Medical Devices and Biocidal Products — applies EU MDR; leech-specific regulation has not been independently verified by ASH.
HALMED — Croatia
Croatia's agency for medicinal products and medical devices — applies EU MDR; leech-specific regulation has not been independently verified by ASH.
DAV / MOH-MD — Vietnam
Vietnam's Ministry of Health medical-device and pharmaceutical authorities — leech-specific regulation has not been independently verified by ASH and may fall under traditional-medicine carve-outs.
Thai FDA — Thailand
Thailand's FDA under the Ministry of Public Health — leech-specific regulatory status has not been independently verified by ASH; Thai traditional medicine has separate statutory framework under the DTAM.
BPOM — Indonesia
Indonesia's national agency for drug and food control — leech-specific regulatory pathway has not been independently verified by ASH; pengobatan tradisional has a separate framework under the Ministry of Health.
MOHAP — United Arab Emirates
UAE Ministry of Health and Prevention — federal authority over health products; leech-specific regulation has not been independently verified by ASH.
ANMAT — Argentina
Argentina's national administration of drugs, food and medical technology — leech-specific regulatory pathway has not been independently verified by ASH.
ISP — Chile
Chile's Public Health Institute — national reference authority for medicines and medical devices; leech-specific regulatory pathway has not been independently verified by ASH.
ARCSA — Ecuador
Ecuador's national agency for sanitary regulation, control and surveillance — leech-specific regulatory pathway has not been independently verified by ASH.
NAFDAC — Nigeria
Nigeria's national agency for food and drug administration and control — leech-specific regulatory pathway has not been independently verified by ASH.
DMP Morocco — Morocco
Morocco's Directorate of Medicines and Pharmacy under the Ministry of Health — leech-specific regulatory pathway has not been independently verified by ASH.
DRAP — Pakistan
Pakistan's Drug Regulatory Authority — federal authority over therapeutic goods; leech-specific regulatory pathway has not been independently verified by ASH.
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