American Society of Hirudotherapy

Pharmaceuticals and Medical Devices Agency

PMDA · Japan · asia pacific

Regulatory jurisdiction profileJurisdictional reference
Traditional medicinenational regulator

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.

Regulatory Profile

Agency type
national regulator
Region
asia pacific
Country
Japan
Leech status
traditional medicine
Last ASH review
2026-05-25

Relevant Regulation Codes

  • Pharmaceuticals and Medical Devices Act (PMD Act / 薬機法), Law No. 145 of 1960 as amended
  • Medical Practitioners' Act (医師法)
  • Kampo / traditional Japanese medicine framework under MHLW Notification No. 65 (2008)

Prescriber Requirements

  • Ishi (licensed physician under MHLW) is the only licensed prescriber
  • Acupuncturists (hari-shi) and moxibustionists (kyu-shi) have separate licensure but not for leech application
  • Kampo specialisation is a board credential under Japan Society for Oriental Medicine; not federally required

Supply Chain & GMP

Importation requires MHLW notification under PMD Act Art. 14, but as leech therapy lacks formal device classification it operates in a regulatory grey zone — most clinical use is via individual physician import authorisations.

Import/Export Rules

Live invertebrate import via MHLW + Ministry of Agriculture, Forestry and Fisheries (MAFF) Plant Protection Station. CITES Appendix II compliance required.

Reimbursement Context

Japanese National Health Insurance (NHI / 健康保険) does not cover hirudotherapy — treatments are private-pay (自由診療 / jiyu-shinryo).

ASH Editorial Notes

Hirudotherapy adoption in Japan is minimal compared to other Asia-Pacific markets; published clinical use is essentially confined to plastic-surgery flap-salvage at major academic centres (Keio, Tokyo University).

Related Jurisdictions

This website provides educational information and does not constitute medical advice, diagnosis, or treatment recommendations. Medicinal leech therapy carries clinically meaningful risks and should be performed only by qualified clinicians under institutionally approved protocols. FDA 510(k) clearance for medicinal leeches is limited to specific indications; investigational and off-label discussions are labeled accordingly. For patient-specific guidance, consult a qualified healthcare provider.