Therapeutic Use Exemptions (TUE) Procedures

Therapeutic Use Exemptions (TUEs)

• An athlete with a TUE should declare the substance or medication used on the doping control form and specify that a TUE has been granted
• It is recommended, but not mandatory, for the athlete to have a copy of the TUE approval form to show the doping control officer

Submitting a TUE Application

• International athletes should submit a TUE application to the international federation (IF) which is responsible for accepting applications and granting TUEs
• National or lower-level athletes should submit a TUE application to the National Anti-Doping Organization (NADO)

Clarification on TUE Applications

• Medical emergency or acute medical condition requires immediate administration of a Prohibited substance or Method and failure to treat could significantly put the athlete's health at risk
• Exceptional circumstances; not enough time through no fault of the athlete, e.g., a healthy athlete gets a sudden medical condition days before an event and is unable to request a TUE in the allotted time

Requirements for a TUE Application

• Identify the athlete's level of competition, sport, and where appropriate, discipline and specific position or role
• List any previous and/or current TUE requests, the body to whom that request was made, the decision of that body, and the decisions of any other body on review or appeal
• Include athlete's comprehensive medical history and the results of all examinations, laboratory investigations, and imaging studies relevant to the application
• Include a statement by an appropriately qualified physician giving valid reasons a prohibited substance or method needs to be used in treating the athlete's medical condition and why alternative medications could not be used

Criteria for Granting a TUE

• Athlete would experience significant health problems without the use of the prohibited substance or method
• Therapeutic use of the substance or method would not result in significant enhancement of performance other than the one that can be attributed to the return to a normal state of health after the treatment of the medical condition
• There is no reasonable therapeutic alternative to the use of the otherwise prohibited substance or method
• The necessity to use a prohibited substance or method must not be the consequence, total or partial, of a prior non-therapeutic use of a prohibited substance

Who Grants a TUE?

• International Federations and National Anti-Doping Organizations have a process in place for granting TUEs through a panel of independent physicians called a Therapeutic Use Exemption Committee (TUEC)

What Happens if an Athlete has a TUE?

• TUEs are granted for a specific medication with a defined dosage
• TUEs are also granted for a specific period and therefore have an expiry date
• The athlete is required to comply with all the treatment conditions set out in the TUE application

What Should an Athlete Do If Already Having a TUE Granted by a NADO but Becomes Subject to the TUE Requirements of an IF or MEO?

• The athlete should not submit an application for a new TUE to the IF or MEO, but should consult their website to check whose TUE decisions they will automatically recognize

What Happens If the IF Refuses to Recognize the NADO TUE?

• The TUE is not valid for international-level competition
• The athlete or NADO can appeal to WADA within 21 days, the TUE remains valid for national-level competition pending WADA review