Therapeutic Use Exemptions (TUEs)

What is the application process for a TUE?

When prescribed a substance or method, athletes should find out whether the medication is prohibited by checking the Global DRO. If the medication is not prohibited, athletes can start using the prescribed medication or treatment.

If the medication is prohibited, athletes should check with their prescribing physician or the sport’s medical personnel to see if there are any alternative medications or treatments that are permitted.

If there are no permitted alternatives, athletes should contact their National Governing Body (NGB) or follow the guidance on the UKAD website to find out if a TUE is required prior to use or after doping control.

International athletes should apply to their International Federation for a TUE. Athletes competing at a national level should apply to UKAD for a TUE.

National and international level athletes must apply for a TUE in advance. The TUE must be granted before the commencement of use of any banned substance or method. Only in emergency situations (such as an allergic reaction, exacerbation of asthma, or the onset of Bell’s palsy) should treatment begin prior to receiving the necessary approval.

How robust is UKAD’s TUE approval system?

UKAD has a number of controls in place to make it as difficult as possible for athletes to misuse the TUE system.

For instance, UKAD has a TUE Committee (TUEC) in place that comprises of 10 doctors with a range of medical expertise (e.g. endocrinology, rheumatology) and most who have experience working within sport treating athletes.

From this Committee, three doctors are selected to form a review panel based on the specifics of an athlete’s application. In order for a TUE to be granted, the panel must be unanimous in their decision that the application meets the WADA criteria for granting a TUE (i.e. the application is rejected if one of the panel members is not in agreement with the rest of the panel).

TUEs are also granted for defined periods of time only and the TUEC often add conditions of approval or conditions for renewal (e.g. a further medical update is required by the TUEC during the exemption period or at the point that the athlete’s TUE expires and they need to renew the TUE).

UKAD also has a designated Medical Officer to monitor the consistency of TUEC decisions, trends within athlete applications, and to ensure that the terms of each TUE (i.e. the conditions of approval/renewal) are upheld by athletes, otherwise the granted TUE can be revoked by UKAD.

UKAD have also created an Independent TUE Review Panel which meets on an annual basis to review the TUEC decisions for a sample of cases over the previous year and to monitor trends (e.g. applications for the same medical condition or prohibited substance).

Furthermore, UKAD submits all decisions to the WADA Medical Department via ADAMS (Anti-Doping Administration and Management System) for their review.

How much and what support does UKAD give to its athletes with regards to their medication and what they can/cannot take?

UKAD has developed a robust education and information programme with NGBs who are responsible for its delivery to their members. UKAD supports the education of athletes and athlete support personnel from beginner to elite athletes.

Known as 100% me, the UKAD programme supports, informs and educates athletes throughout their careers by providing anti-doping advice and guidance in person and online.

The Global Drug Reference Online (Global DRO) provides athletes and support personnel with information about the prohibited or permitted status of specific medications based on the current World Anti-Doping Agency (WADA) Prohibited List.

For more information on Therapeutic Use Exemptions please visit the UKAD website.

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