Explainer: Therapeutic Use Exemptions

A Therapeutic Use Exemption (TUE) is an exemption that authorises an athlete to use, for therapeutic purposes only, an otherwise banned substance or method (of administering a substance) according to WADA's Prohibited List.

Athletes, like all others, may have illnesses or conditions that require them to take particular medications.

If the medication an athlete is required to take to treat an illness or condition falls under the WADA's Prohibited List, a TUE may be granted. It's important to note that it is not easy to obtain a TUE as it will only be provided under well-defined and restricted conditions.

These conditions are set out in the International Standard for Therapeutic Use Exemptions (ISTUE). These guidelines, established by WADA, regulate and govern the process of granting TUEs in sport. The ISTUE has been in place since 2004 to ensure that the process of granting a TUE is harmonised across sports and countries. Remember that harmonisation stuff you learned in your EU law classes? Well, that principle can be applied here.

Harmonisation 🌍

The concept of harmonisation means that the process and rules are consistent across various sports and countries. 

This ensures that the rules, procedures, and criteria for granting a TUE are uniform, transparent, and synchronised. All of this promotes fairness and equality in the way the procedure is carried out. 

The Granting Criteria 📝

There are four criteria set out in Article 4.2. of ITSUE that must be met for a TUE to be granted. The TUE will be granted only if all the conditions listed in Article 4.2 are met.

1. The prohibited medication in question is needed to treat a diagnosed condition supported by relevant clinical evidence

2. The therapeutic use of the prohibited medication will not (on a balance of probabilities) enhance performance beyond what might be expected by a return to the athlete’s normal state of health following the treatment of the medical condition.

3. The prohibited medication is an indicated treatment for the medical condition, and there is no reasonable permitted therapeutic alternative; and

4. Using the prohibited medication shouldn't be needed because you used something forbidden before (without permission), which caused the need in the first place.

   
   

Important to remember 👇

1. Not all medications are eligible for a TUE and having a TUE will only guard against a possible anti-doping rule violation if the medication is used as per the TUE.

2. The Prohibited List is updated once a year; and

3. There is possibility to obtain either an in-advance TUE or a retroactive TUE. The same medical information is required when applying for an in-advance or retroactive TUE.

To read more on TUEs click here.