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Japan: Therapeutic / Stem Cell

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Lightly Regulated

Gene therapy permitted and can be approved through an accelerated system that requires minimal clinical trial data for safety and effectiveness.

Gene therapy is permitted and approval can be fast-tracked through an accelerated system that is unique to Japan. After short, small clinical trials for safety and effectiveness, regenerative medicines (therapies that repair tissues and organs, including gene therapy) can be approved on a conditional basis that allows for the marketing, sale, and use of the treatment. Additional data collection is required for seven years, after which researchers can apply for final marketing approval.

Some scientists have voiced concerns that the approval system risks marketing unsafe or ineffective drugs and that it is unclear how evidence of safety and effectiveness will be collected after treatments are on the market.

Gene and stem cell therapies are regulated by two agencies. The Ministry of Health, Labor and Welfare (MHLW) is responsible for implementing safety standards for drugs. The Pharmaceuticals and Medical Devices Agency (PMDA) is an independent agency that works with MHLW to review drug applications and monitor post-market safety. PMDA functions under the Pharmaceutical and Medical Devices Act, adopted in 2014. The Act introduces conditional approval of treatments that have gone through minimal clinical testing, which allows for the immediate marketing and use of the treatment. Companies must continue to collect data on the treatment’s effectiveness for seven years in order for the treatment to receive final marketing approval.

As of 2019, three stem cell treatments have earned conditional approval through the accelerated system. Outside of stem cell therapies, there are no other approved gene therapy products.


  • Stem cell treatment for paralysis: Sapporo Medical University received accelerated approval for the sale of a stem cell treatment for spinal cord injuries, called Stemirac, the first approval worldwide for a therapy for these types of injuries. Some scientists voiced concerns that there is insufficient evidence that the therapy works and is safe.
  • Stem cell treatment for lack of blood to limbs: Sapporo Medical University used blood-forming stem cells to treat critical limb ischaemia, a condition in which a limb does not receive enough blood due to a blockage in an artery.
  • Cornea repair: Osaka University used reprogrammed stem cells to repair the cornea to treat a patient’s vision loss.
  • Human organs in animals: University of Tokyo received approval to grow human organs in rats and mice. The research is in early stages, but the goal is to develop human pancreases that can be transplanted into humans.

Regulatory Timeline

2017: Conditional Prompt Marketing Approval Designation, which allows developers to gain conditional marketing approval with minimal clinical trial requirements if enough patients with a rare disorder cannot be recruited, is introduced.

2015: The Guidelines of Clinical Research Regarding Gene Therapy, which regulates clinical research on gene therapy, passes.

2014: Japanese government adopts accelerated approval system for regenerative medicines, including gene therapy and stem cell treatments. The Pharmaceuticals, Medical Devices, and Other Therapeutic Products Act (PMD Act) introduces conditional approval, which requires only minimal safety and efficacy data. The Act on the Safety of Regenerative Medicine accelerates the clinical application and commercialization of regenerative medicine.

2013: Regenerative Medicine Promotion Act passes in response to the discovery of induced pluripotent stem (iPS) cells (adult stem cells that can develop into any type of cell) by Shinya Yamanaka in 2006.

2006: Guideline for Human Stem Cell Clinical Research is published.

NGO Reaction


Additional Resources

Click on a country (eg. Brazil, US) or region (eg. European Union) below to find which human / health products and processes are approved or in development and their regulatory status.

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Human / Health Gene Editing Index
Compare Regulatory Restrictions Country-to-Country

Gene editing regulations worldwide are evolving. The Gene Editing Index ratings below represent the current status of gene editing regulations and will be updated as new regulations are passed.

Colors and ratings guide

Regulation StatusRating
Determined: No Unique Regulations*10
Lightly Regulated8
Proposed: No Unique Regulations†6
Ongoing Research, Regulations In Development5
Highly Regulated4
Mostly Prohibited2
Limited Research, No Clear Regulations1
Lightly Regulated: Gene and stem cell therapies regulated with minimal restrictions and requirements.
*Determined: No Unique Regulations: Gene and stem cell therapies regulated as phamaceuticals with no additional restrictions.

†Proposed: No Unique Regulations: Decrees under consideration for gene and stem cell therapies that would not require unique regulations beyond current restrictions on pharmaceuticals.

Gene editing of adult human cells, including gene therapy and stem cell therapy, that is used to treat and cure disease. Recent breakthroughs include CAR T-cell therapy, which uses patients’ own immune cells to treat their cancer.
Gene editing of the human embryo or germline that results in genetic changes that are passed down to the next generation. This type of gene editing is the most controversial because changes are inherited and because it could theoretically be used to create “designer babies”. A Chinese scientist announced in 2018 that he had successfully edited twins that were brought to term. International backlash from the announcement has resulted in China and other countries working to clarify regulations on germline gene editing.

Rating by Country / Region
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Country / RegionTherapeuticGermlineHuman Rating
New Zealand402
Central America111
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Gene editing is a set of techniques that can be used to precisely modify the DNA of almost any organism. It is being used for applications in human health, gene drives and agriculture. There are numerous gene-editing tools besides CRISPR-Cas 9, which gets most of the attention because it is a comparatively easy tool to use.

Gene editing does not usually involve transgenics – moving ‘foreign’ genes between species. It also refers to a specific technique in contrast to the general term GMO, which is scientifically ambiguous, as genetic modification is a process not a product. Most gene editing involves creating new products by deleting very small segments of DNA (sometimes in agriculture called Site-Directed Nuclease 1 or SDN-1 techniques), which can silence a gene or change a gene’s activity. Countries are evaluating whether or not to regulate this type of gene editing, since it is so similar to natural mutations. The GLP’s Gene Editing Index ratings reflect the regulatory status of SDN-1 techniques, which are the most liberally regulated and will generate most products in the near term.

To develop different products, gene editing can change larger segments of DNA or add DNA from other species (a form of transgenics sometimes in agriculture called SDN-2 or SDN-3 techniques). While many countries are not regulating or lightly regulating SDN-1 techniques, most are moving toward tightly regulating or even restricting SDN-2 and SDN-3.

For more background on the various gene editing SDN techniques, read background articles here and here.