Therapeutic Use Exemption (TUE)

International Standard for Therapeutic Use Exemption (ISTUE)

The International Standard for Therapeutic Use Exemptions is a mandatory International Standard developed as part of the World Anti-Doping Program.

The purpose of the ISTUE is to establish

• the conditions that must be satisfied in order for a Therapeutic Use Exemption (or TUE) to be granted, permitting the presence of a Prohibited Substance in an Athlete’s Sample or the Athlete’s Use or Attempted Use, Possession and/or Administration or Attempted Administration of a Prohibited Substance or Prohibited Method for therapeutic reasons;
• the responsibilities imposed on Anti-Doping Organisations (ADO) in making and communicating TUE decisions;
• the process for an Athlete to apply for a TUE;
• the process for an Athlete to get a TUE granted by one ADO recognised by another ADO;
• the process for WADA to review TUE decisions; and
• the strict confidentiality provisions that apply to the TUE process.

WADA Therapeutic Use Exemption Guidelines

This TUE Guidelines document takes ADOs through the lifecycle of the TUE, starting with the criteria for granting a TUE.

The Guidelines bring forward key ADO responsibilities, including support of Athletes making TUE applications, recognition of TUEs, and communication of TUE decisions. Confidentiality provisions and WADA’s role in the review of TUE decisions are also addressed.

These Guidelines are not mandatory, but are intended to give clarity and additional guidance to Code Article 4.4 and the ISTUE, each of which is mandatory.

Other Useful Links

WADA Q&A on Therapeutic Use Exemption
WADA Checklists for TUE applications