The Precision Blog

How South Korea Became a Leading Destination for Clinical Trials

Written by Helen Ormandy, PhD | Sep 5, 2024 12:48:03 PM

The rise of South Korea in global clinical research

Emerging markets play an increasingly important role in clinical research. Amongst these, South Korea has distinguished itself as a prominent destination for clinical trials.

Historically, clinical trials were predominantly conducted in North America and Western Europe. However, by 2021 approximately half of all the clinical trial starting in that year included a trial site in APAC.1 This shift has been driven by factors such as the need for larger and more diverse patient populations, cost considerations, and the globalisation of the pharmaceutical industry.

South Korea's rapid growth in clinical trial numbers

South Korea's emergence can be traced back to the early 2000s when the country's government recognised the potential of clinical research to be a significant contributor to economic growth. What followed was a series of strategic initiatives aimed at developing South Korea's capacity for conducting high-quality clinical research.

According to data from Citeline’s Trialtrove®, the number of clinical trials conducted in South Korea increased from just 48 in 2000 to over 1,000 annually by 2021.2 This represents a growth rate far exceeding the global average.

The significance of South Korea's emergence represents a shift in the global distribution of clinical research capabilities, potentially influencing drug development strategies, regulatory harmonisation efforts, and the overall conduct of international clinical trials.

Precision for Medicine established a legal entity in South Korea in July 2023. This provided a base for our staff with expertise in clinical operations, including site management and monitoring, and in regulatory submissions, consultations, and reporting.  

 

Key advantages of conducting clinical trials in South Korea

Factors that make South Korea an attractive destination for conducting clinical research include

  • advanced medical infrastructure
  • fast start-up with streamlined IND and IRB/EC submissions in parallel
  • strong government support for R&D and accreditation of trial centres
  • strong recruitment with a high population density and 97% of the 51 million population under national health insurance3
  • experienced research professionals receiving mandatory government GCP training.

South Korea's clinical trial landscape: By the numbers

With a population of 51.6 million and a GDP of 1740.9 billion USD (11th globally in 2022), South Korea boasts the world’s top-ranked health care system.4

12th biggest country in the global pharma market5 3 weeks (on average) for IRB Submission to Approval4
97% of the population is covered by National Health Insurance3 30 working days needed from MFDS-CTA application to approval4
TOP 5 country globally for conducting clinical trials5 200+ medical institutions designated by the MFDS as qualified clinical trial sites5
#1 ranked city (Seoul) for number of clinical trials per city since 20175 26 dedicated Phase I research units5
Zero OAIs (Official Action Indicated) from FDA inspection (~2008-2022) 5 >714 research beds5

Top Clinical Trial Sites in South Korea

The South Korean Government has fully-certified around 200 clinical trial sites, with about half of these in Seoul and surrounding districts. 

Top 10 Sites in South Korea6
  1. Samsung Medical Center (Seoul)
  2. Asan Medical Center (Seoul)
  3. Seoul National University Hospital (Seoul)
  4. The Catholic University of Korea, Seoul St Mary’s Hospital (Seoul)
  5. Severance Hospital (Seoul)
  6. National Cancer Center (Seoul)
  7. Seoul National University Bundang Hospital (Seoul greater district)
  8. Chonnam National University Hwasun Hospital (Gwangju)
  9. Korea Institute of Radiological & Medical Sciences (Seoul)
  10. Korea University Guro Hospital (Seoul)

South Korea's global ranking in sponsor-initiated clinical trials

Over the last few decades, sponsors have increasingly invested in trials in South Korea, in recognition of its benefits. South Korea is particularly renown for early-phase research and oncology trials. Data depicted below shows Korea in 6th place for sponsor-initiated trials globally. In 2023, South Korea’s ranking rose to 4th place.7

Industry-Sponsored Interventional Drug Trials in Top Tier Countries, 2018-20225

South Korea's pharmaceutical industry on the rise

The Korean pharmaceutical industry is already the 13th largest world-wide and is ramping-up R&D investments to break into international markets. These initiatives now encompass a broad range of areas, including cutting-edge new drugs, platform technologies, medical devices, healthcare IT solutions, and modified drugs. In 2016, the Korean Ministry of Food and Drug Safety (MFDS) became a member of the International Council for Harmonization (ICH). Additionally, Korea’s robust intellectual property rights protection further invigorates R&D.

The Clinical Trial Authorisation and EC process in South Korea

The Clinical Trial Authorisation (CTA) process allows simultaneous submission of applications to the MFDS and IRBs/ ECs. After submission, the MFDS responds with either trial approval or a request for additional information within 30 working days. IRB/EC reviews are conducted through monthly meetings at the site level, typically taking about 3 weeks for approval, with expedited reviews when necessary. Recently, mutual recognition of central IRB/EC approvals across participating sites has been introduced, accelerating the review process. Overall, the review timeline for both MFDS and IRB/EC averages between 4 to 8 weeks.

South Korea has highly competitive start-up timelines compared to other major countries for clinical trials. Data published by a top 10 pharmaceutical company shows Korea ranking 6th amongst 16 top tier countries with a timeline of 112 days from the CTA package to first Site Initiation Visit.5

The critical path to activation for South Korea


South Korea's commitment to clinical trial excellence

Clinical institutions undergo routine inspections by the MFDS and have a strong track record with audits from international regulatory bodies such as the US FDA, EMA, and PMDA. Clinical trials are internally monitored by the internal audit team in the Clinical Trials Centres for major Institutions. From October 1, 2008, to October 9, 2019, the US FDA’s CDER conducted 39 inspections in Korea, all of which resulted in no Official Actions Indicated (OAI).

All clinical trial site staff must complete a mandated number of annual training hours in GCP by the MDFS.

IRBs/ECs at major sites across Korea are accredited by international organisations like FERCAP and AAHRPP, ensuring robust oversight of human research protection.

Proceed with Precision

South Korea offers compelling opportunities for sponsors thanks to an advanced medical infrastructure, streamlined regulatory processes, and high-quality research capabilities. However, capitalising on these advantages takes a partner with specialised expertise. Precision for Medicine's global capabilities provide a crucial bridge between South Korea's local strengths and international clinical research requirements.

Learn how Precision can position your development program to take advantage of emerging opportunities in Asia Pacific. 

 

References
  1. https://invivo.citeline.com/IV146738/APAC-As-A-Clinical-Trial-Powerhouse
  2. https://clinicalintelligence.citeline.com/
  3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9353560/
  4. CEOWorld Magazine’s Health Care Index. https://www.theglobaleconomy.com/
  5. Korean National Enterprise for Clinical Trials 2023. Start with Korea.
  6. https://medigatenews.com/news/511209617
  7. http://www.hitnews.co.kr/news/articleView.html?idxno=54621