Therapeutic Use Exemptions

Athletes may have illnesses or conditions that require them to take medications. If the medication an athlete is required to take to treat an illness or condition happens to fall under the Prohibited List (List) a Therapeutic Use Exemption (TUE) may give that athlete the authorization to take the needed medicine.

International Standard for Therapeutic Use Exemptions (ISTUE)

The purpose of the International Standard for Therapeutic Use Exemptions (ISTUE) is to ensure that the process of granting TUEs is harmonized across sports and countries.

TUE Application Process

Before taking any medication, an athlete must check the status of the medication on the List or with their Anti-Doping Organization (ADO). If the substance is prohibited, the athlete will need to apply for a TUE.

WADA outlines the rules and process, hears appeals and monitors TUE decisions made by ADOs. Athletes do not apply to WADA for a TUE.

WADA Guidance

WADA has produced checklists and documentation to support athletes, their physicians and ADOs during the TUE application and decisions processes.

  • Checklists for TUE Applications: Based on the TUE Physician Guidelines, the Checklists outline the specific requirements for completing the TUE Application Form based on the medical/health condition requiring the treatment. The Checklists cover the most commonly seen conditions and include the medical evidence that must be submitted along with the application.
  • TUE Physician Guidelines: The objective of these documents is to provide Therapeutic Use Exemption Committees (TUECs) with medical information to support the decision-making process for TUE applications. These are not mandatory documents. The documents should be read in conjunction with the principles set out in the ISTUE regarding the granting criteria for TUEs (Article 4.1 to 4.3).

These ‘living documents’ are updated as necessary based on the evolution of medical best practice. Pathologies covered at this time are the most current ones encountered in the TUE field. This is not an exclusive list and TUEs for any other medical condition may be considered based on the principles of the ISTUE.