Since the 2000s, medical science researches in South Korea have been governed by three major laws - the Bioethics and Safety Act, the Pharmaceutical Affairs Act, and the Medical Devices Act. The Pharmaceutical Affairs Act is in charge of regulating clinical trials that authorize new medical products; meanwhile, human subject researches other than clinical trials are subjects to the Bioethics Act. However, the development of new cutting-edge medical research, such as new health technology and 3D printers, has gradually blurred the boundaries of clinical trials and non-clinical trials. Governance system has been challenged by demands from medicine and pharmaceutical industry, especially in areas other than clinical trials. For example, in South Korea, clinical trials should be conducted only in clinical trial institutions under the Pharmaceutical Affairs Act and the Medical Devices Act. Besides, the number of cases is growing to offer highly advanced treatments such as cellular therapy and conduct human subject research other than clinical trials, which can demonstrate positive effects without complying with the strict standards of clinical trials. Developing new medical products and devices or developing off-label uses of existing medicines and medical devices is subject to the application of 'clinical tests' under the Pharmaceutical Affairs Act and the Medical Devices Act. Meanwhile, examining these new medical techniques with existing medical procedures is often ambiguous to apply to the Pharmaceutical Act. Although the Advanced Regenerative Medicine Act was enacted in August 2019 to fill these regulatory gaps, there is a limit to providing regulations equivalent to the previous level of regulations.
This study explores two examples of challenging the boundaries of these clinical trials and non-clinical trials: cellular therapy and 3D bioprinter technology. In the case of cellular therapy, if it is proven effective through treatment in a hospital, the government recognizes the treatment as a 'limited medical technology' and is allowed to introduce clinical trials. However, the KFDA believes that research on the effectiveness of medical treatment is not a traditional clinical trial. This position, which strictly distinguishes medicines from medical treatment, makes it difficult to assess the ethics and safety of medical treatments. 3D bioprinter technology is also controversial whether each of the equipment made by this technology is a new medical device. Every time 3D bioprinter makes products, evaluating compatibility with regulations, and developing guidelines toward the components of products becomes uneasy tasks for industries and authorities. If advanced medicine evolves into a pre-created, clinical, fast-track in the future, like precision medicine, it is likely to challenge a standardized regulatory approach, and difficult to interpret as traditional clinical trials. Such cutting-edge medical treatments are expected to pose a new challenge to Korea's medical science regulations in the future.