UPDATED: October 22, 2024
It’s to be expected that athletes may experience medical conditions over the course of their sport careers, which may require that they use a medication or receive medical treatment. If the substance or method prescribed to treat that medical condition is prohibited by the World Anti-Doping Agency (WADA), athletes can apply for a Therapeutic Use Exemption (TUE), and if granted, obtain permission to use a prohibited substance or method for a specified time period.
If you are unsure whether your medication or method is permitted in sport, please visit GlobalDRO.com to check its prohibited status.
The USADA TUE Policy outlines the requirements for every step of the TUE process, including the application requirements, review process, and criteria for TUE approval.
An Independent Review Process
Under the USADA and PFL TUE Policies, TUE applications are reviewed by medical professionals who are members of an independent TUE Committee (TUEC), which must be comprised of medical experts with various areas of medical specialty, ranging from endocrinology to psychiatry. The USADA TUEC currently includes more than 20 medical professionals, many of whom are practicing physicians, work with athletes, and publish research in their field of specialty.
Every TUE application is reviewed by at least two members of the TUEC, who conduct an individual and independent review of TUE applications assigned to them. To ensure anonymity, each application is redacted to remove the athlete’s name, personal contact information, and anything that would otherwise identify the athlete (e.g. patient ID number).
Having A Prescription is Not Enough
Every TUE application is judged on its medical merits and ability to satisfy specific criteria, so it’s important that athletes have more than just a doctor’s prescription. In competitive sport, it’s essential that athletes have documentation of a medical condition with a confirmed diagnosis, rationale for why non-prohibited alternatives are not medically appropriate, and a clear treatment plan to show that they require the prohibited substance or method. Betterment of generalized symptoms alone is not sufficient justification to obtain a TUE.
Under the TUE Policies, an athlete has the responsibility to demonstrate that they can satisfy four criteria for TUE approval before they are granted permission to use a prohibited substance or method. Based on the criteria, the athlete must show that the prohibited substance or method is needed to treat an acute or chronic condition, and that the treatment will only return the athlete to their normal level of health, without offering any performance-enhancing benefits. Moreover, the athlete must be able to show that the prohibited substance or method is necessary because there are no other reasonable treatment alternatives, and that any previously used treatments were ineffective.
From the documentation provided, the USADA TUEC needs to be able to arrive at the same diagnosis and treatment plan as the athlete’s physician without seeing the athlete. In general, a TUE is required in advance of using a medication, but specific rules vary based on the level of the athlete, the specific medication, and the circumstances of use. To be safe, complete our short USADA TUE Pre-Check form to determine if you require a TUE.
Top Reason for Returned Applications
One of the top reasons TUE applications are returned to athletes before going to the TUEC is because the applications are incomplete. Some examples of why an application is incomplete are, they are either missing required signatures on the application form, they didn’t use the right USADA TUE application form, and/or they are lacking essential medical information. A four-page USADA TUE application form alone will be returned back to the athlete.
Many times, rushing through the first few steps of the application process becomes problematic, so it’s important for athletes and support personnel to select the appropriate application, fill it out completely and legibly, and supply the appropriate medical guidance document outlined in our USADA Checklists found under Step 1.
To further protect athletes’ information, USADA has created an online web portal for your TUE Application submissions. Please visit Step 5 to securely submit your combined TUE Application.
For more information on the TUE application process, visit the USADA TUE section.