Therapeutic Use Exemptions (TUEs)


Since 2020, the management of TUEs is handled by the International Testing Agency (ITA). You can find all the necessary information on the website.

Athletes, like all people, may have illnesses or conditions that require them to take a particular medication/substance or undergo certain procedures/methods. If the substance or method appears on WADA’s List of Prohibited Substances and Methods, athletes must obtain a Therapeutic Use Exemption (TUE) in order to have the permission to participate in their sport.

A TUE is a certificate granted by an Anti-Doping Organisation (WBSC for International-Level Athletes, NADO for national-level athletes and MEO for athletes participating in an MEO event). The certificate is for a set prohibited substance, in certain dosages, with a limited period of validity.

WHAT ARE THE CRITERIA FOR GRANTING A TUE?

All of the four following criteria must be met (for more details, please refer to the art. 4.1 of the WADA International Standard for Therapeutic Use Exemptions (ISTUE):

WHO SHOULD APPLY FOR A TUE TO WBSC, WHERE AND WHEN?

First, check if the required medication or method you intend to take or use appears on the Prohibited List.
Please refer to the Global Drug Reference Online (Global DRO), the online country-specific drug reference database. It provides athletes and support personnel with information about the prohibited status of specific medications based on the current World Anti-Doping Agency (WADA) Prohibited List.

You have the responsibility to inform your doctors that you are an athlete subject to doping control, and your doctors should check the Prohibited List whenever they prescribe a medication / method to you. If the substance / method is prohibited, check with your doctors if there are any alternative treatments that are not prohibited. If not, you must apply for a TUE. You should also not assume that all medical professionals who prescribe medication have a full understanding of anti-doping-related matters in their sport.

Second, check your competition level to determine to which organization, and when to apply for a TUE.

If you are an International-Level Athlete ‒ defined as athlete who is part of the WBSC Registered Testing Pool and WBSC Testing Pool and/or who participates in select WBSC International Events as published by WBSC on its website ‒ you must apply for a TUE to WBSC in advance, as soon as the need arises.

In particular you must apply to WBSC if:

If you already have a TUE granted for national-level competitions by your NADO (in the list below *), that TUE is automatically valid for international-level competition and it is not necessary to apply to WBSC for recognition, provided that such exemption has been granted in accordance with Article 5.4 of the International Standard for TUE.

* NADOs with agreement with WBSC for TUE mutual recognition: USA, JPN, KOR, CUB, MEX, TPE, CAN, AUS, NED, PUR, NZL, ARG, CZE, HKG, ITA, GER.

HOW INTERNATIONAL-LEVEL ATHLETES APPLY TO WBSC FOR A TUE?

You must use exclusively the TUE application form available in ADAMS, and the required medical file must also be submitted via ADAMS.

If you have challenges to send the form via ADAMS, please contact WBSC to tue@ita.sport and attach the form (EN  –  FR) filled in all its parts.
Here you can find the Spanish version but only the English or French version will be taken in consideration.

The medical file includes:

If the medical file is not in English or French, a summary explaining, in English or French, the key elements of the diagnosis, clinical examinations, medical tests and treatment plan must be provided.

Any TUE application that is not complete or legible will not be dealt with and will be returned for completion and re-submission.

To assist you and your doctor in providing the correct medical documentation, we suggest consult the WADA’s Checklists for TUE applications for guidance and support, and Medical Information to Support the Decisions of TUECs for guidance on specific common medical conditions, treatments, substances, etc.

Keep a complete copy of the TUE application form and all medical information submitted in support of your application, and proof that it has been sent.

In accordance with the WBSC Anti-doping Rules, TUE applications shall be sent at least forty-five (45) days before your next competition.

For further information, please refer to your treating physician, consulting the medical information available on WADA’s website to support the decisions of TUE committees.

Each TUE application will be carefully evaluated by a WBSC delegate in ITA and will only be granted in accordance with the International Standard for TUE criteria laid out in article 4. If the exemption is granted, the athlete will then be permitted to use the medication during the period of validity of the TUE without committing an Anti-Doping Rules Violation (ADRV).

WADA’s role in the TUE process is two-fold. First, the Agency, through its TUEC, has the right to monitor and review any TUE granted by an ADO and, following such review, to reverse any decision. Second, an athlete who submits a TUE application to an ADO (WBSC or NADO) and is denied, can ask WADA to review the decision. If WADA determines that denial did not comply with the ISTUE, the Agency can reverse the decision. WADA itself does not accept TUE applications from athletes.

ONCE A TUE IS GRANTED

Athletes selected for doping control must systematically (i.e. regardless of the presence of a TUE) declare on the doping control form the use of all prescribed and over-the-counter medications as well as supplements taken in the last 7 days and any blood transfusions in the 3 months prior to blood samples.

WHAT HAPPENS IF A TREATMENT INVOLVES PROHIBITED SUBSTANCES/METHODS AND YOU DO NOT HAVE A TUE?

The use or attempted use, possession, administration or attempted administration of a prohibited substance or method on WADA’s Prohibited List, before or without TUE approval, will most likely result in an Anti-Doping Rule Violation (ADRV).

For more general information about TUEs please visit WADA TUEs section.

For any request, clarification or doubt please contact: tue@ita.sport

CAN I GET A RETROACTIVE TUE?

You may only apply retroactively for a TUE to WBSC if:

Important notes:

Using a prohibited substance before being granted a TUE could result in an Adverse Analytical Finding and a potential anti-doping rule violation.

In case an application for a retroactive TUE is necessary following sample collection, you are strongly advised to have a medical file prepared and ready to submit for evaluation.

NUTRITIONAL SUPPLEMENTS

Extreme caution is recommended regarding supplement use.

For more information please consult the dedicated section.

WADA’s webpage on TUEs

WADA’s Q&A on TUEs

At a Glance - Therapeutic Use Exemptions (TUEs)