Definition of Therapeutic Use Exemption
A Therapeutic Use Exemption allows an Athlete with a medical condition to use a Prohibited Substance or Prohibited Method. However, only under specific conditions set out in Art 4.2 of the International Standard for Therapeutic Use Exemption.
During their career, Athletes may have an illness or a condition that requires a particular medication or methods of treatment that fall under the Prohibited List.
The Athlete is responsible for informing their medical professional that they are also bound to Anti-Doping Rules. The medical professional must try and provide medication that does not contain any prohibited Substances. If the medication contains a Prohibited Substance, they should discuss a non-prohibited alternative. If not possible, then the Athlete needs to apply for a Therapeutic Use Exemption.
Requirements to obtain a Therapeutic Use Exemption
Therapeutic Use Exemptions are mentioned in International Standards to make sure the process of granting an Exemption is the same in all sports and countries. An Athlete will be granted a Therapeutic Use Exemption only if, they can show, that all of the following conditions are met:
- The Athlete has a clear diagnosed medical condition, supported by clinical evidence, that requires treatment using a Prohibited Substance or Method;
- The health will be significantly impaired if the Athlete does not take the substance;
- The substance does not enhance the performance beyond what brings the Athlete back to normal health;
- There are no alternative treatments available that are not prohibited;
- The need for the use of the Prohibited Substance is not resulting from prior use of a Prohibited Substance.\
Applying for a TUE
Who can apply for a Therapeutic Use Exemption?
Any Athlete who may be subject to doping control must request a Therapeutic Use Exemption to the relevant Anti-Doping Organization before taking a Prohibited Medication.
International Level Athlete
Athletes considered as international level Athletes should apply for their Therapeutic Use Exemption with World Triathlon directly.
International Level Athletes that are all Athletes that are competing in events recongised by World Triathlon and included in the World Triathlon Calendar and in the Elite, Junior, U23, Para Triathlon, and Mixed Relay Programs.
National Level Athlete
They should apply for their Therapeutic Use Exemption directly to the New Zealand Sport Integrity Commission. In cases of where they compete at an international level, they will have to request World Triathlon to recognize the Therapeutic Use Exemption.
Confidentiality of the Medical Information:
All the medical information and related documents contained in a Therapeutic Use Exemption application are strictly confidential and treated in accordance with the applicable law regulation.
When to apply for a Therapeutic Use Exemption?
Athletes who need to use a Prohibited Substance or Method for therapeutic reasons must obtain a Therapeutic Use Exemption before using or possessing the Substance or Method. They must apply for a Therapeutic Use Exemption at least 30 days prior to competing.
What about the renewal of the Therapeutic Use Exemption?
Each Therapeutic Use Exemption has a specific duration and automatically expire when that period ends. If the Athlete needs to continue to use the Prohibited Substance or Method, it is the Athlete’s responsibility to submit a new application for a Therapeutic Use Exemption before the expiry date.
What is a retroactive Therapeutic Use Exemption?
In exceptional circumstances Athletes may apply for a retroactive Therapeutic Use Exemption if, it would be clearly unfair not to grant it.
Retroactive Therapeutic Use Exemption can be applied if:
- The Athlete required emergency or urgent treatment of a medical condition.
- There was not enough time or opportunity for you to submit the Therapeutic Use Exemption application, or having it approved, before getting tested.
- The Athlete is a lower-level Athlete who is not under the jurisdiction of World Triathlon or National Anti-Doping Agency and was tested.
- The Athlete tested positive after using a substance Out-of-Competition that is only prohibited In-Competition (for example glucocorticoids).
How does one apply for a Therapeutic Use Exemption?
1) Submission of the Therapeutic Use Exemption Form to ITA
World Triathlon encourages one to submit Therapeutic Use Exemption and the required medical information applications via ADAMS. If you do not have an ADAMS account yet, please contact tue@ita.sport to have it set up.
Otherwise, please download the Therapeutic Use Exemption Application Form, and once duly completed and signed, gather the required medical file and contact tue@ita.sport
Your Therapeutic Use Exemption application must be submitted in writing, very clearly and using capital letters so it is clear for everyone.
The medical file must include:
- A medical history, including documentation from the original diagnosing physician(s);
- The results of all examinations, laboratory investigations and imaging studies relevant to the application.
- Any costs incurred by the Athlete in making the Therapeutic Use Exemption application.
- Any additional information required are the Athlete’s responsibility.
Any Therapeutic Use Exemption 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 consulting the WADA’s Checklists for Therapeutic Use Exemption applications for guidance and support.
2) Recognition of the Therapeutic Use Exemption to the ITA
The International Testing Agency’s Therapeutic Use Exemption will automatically recognize your Therapeutic Use Exemption international-level Competitions, without needing to review the relevant clinical information. If the Therapeutic Use Exemption is correctly entered in ADAMS, there is no need to contact us. Nevertheless, should you require a confirmation, you can submit your request to the International Testing Agency in writing quoting your ADAMS Therapeutic Use Exemption reference number.
You can download your Therapeutic Use Exemption certificate directly from ADAMS.
3) Appeal to WADA
A decision to deny a Therapeutic Use Exemption application will include a written explanation of the reasons for the denial. The Athlete or the National Anti-Doping Organization may refer the matter directly to WADA for review no later than 21 days after notification of the World Triathlon Therapeutic Use Exemption Committee decision.
To appeal the decision, the Athlete shall send the same information as the one submitted to World Triathlon, and on which the decision to deny the Therapeutic Use Exemption was based on.
It can be done by post at the following address:
WADA Medical Department
World Anti-Doping Agency
Stock Exchange Tower
800 Place Victoria (Suite 1700)
P.O. Box 120
Montreal (Quebec) H4Z 1B7
Canada
The email address to enquire or send the request for review is: medical@wada-ama.org
Use of Medication
During an Athlete’s career, an Athlete may have to take various medications. With or without a doctor prescription, it is the Athlete’s responsibility to check the medication before taking it, even if it is something that has been used in the past.
World Triathlon refers to the module about the Prohibited List and the precaution Athletes must take when using medications.
Checking the Medication Status
Every time you buy a medication (prescribed or not), check the Prohibited List to see if one of the ingredients is on it. You can ask your doctor, the pharmacist, or the New Zealand Sport Integrity Commission.
You can use online resources such as GlobalDRO. You can search the status of your medication, see if it contains Prohibited Substances or not. Please note that this is only for medication, and not for supplements.
Combination of Prohibited Substance
Some Substances can be prohibited when combined with other Substances. For example, if any amount of substance with a threshold limit (such as formoterol, salbutamol) is found with a diuretic or masking agent, it will be considered a positive test if the Athlete does not have Therapeutic Use Exemption for both Substances.
Useful tips
- During a test: declare mention the any approved Therapeutic Use Exemption and all medications you took the last 7 days on the Doping Control Form
- Specify that you have a Therapeutic Use Exemption (you do not need to show the Therapeutic Use Exemption approval during doping control)
- Tell medical professionals that they must follow the Anti-Doping Rules and the Prohibited List (do not hesitate to take the Prohibited List with you)
- Check with the relevant Anti-Doping Organization if you need to apply for a Therapeutic Use Exemption before using a medication that contains a Prohibited Substance
- Ask medical professionals if you need a Therapeutic Use Exemption prior to receiving medical treatment
- Apply for a Therapeutic Use Exemption with the relevant Anti-Doping Organization
- Check the Therapeutic Use Exemption expiry date and do not forget to renew it if needed
- Take all the precautions when using medications
