Therapeutic Use Exemption (TUE)

What is a Therapeutic Use Exemption?

Athletes may at times need to use a prohibited medication and/or method to treat a legitimate medical condition. A Therapeutic Use Exemption (TUE) is an exemption that allows an athlete to use, for therapeutic purposes only, an otherwise prohibited substance or method (of administering a substance).

Therapeutic Use Exemptions are administered by the Australian Sports Drug Medical Advisory Committee (ASDMAC). Find out more about ASDMAC.

If an athlete or their doctor has a question regarding the status of a substance:

• They should check the substance on the  Global DRO website
• Or call this phone number: +61 2 6222 4283

Under the World Anti-Doping Code–International Standard-Therapeutic Use Exemptions (2023) an athlete may be granted a Therapeutic Use Exemption if (and only if) they can show, on the balance of probabilities, that each of the following conditions are met:

• The prohibited substance or method is needed to treat a diagnosed medical condition supported by relevant clinical evidence.
• The therapeutic use of the prohibited substance or method will not, on the balance of probabilities, produce any additional enhancement of performance beyond what might be anticipated by a return to the athlete’s normal state of health following the treatment of the medical condition.
• The prohibited substance or method is an indicated treatment for the medical condition, and there is no reasonable permitted therapeutic alternative.
• The necessity for the use of the prohibited substance or method is not a consequence of the prior use (without a TUE) of a substance or method prohibited at the time of such use.

An Athlete who needs a TUE should apply as soon as possible. For substances prohibited In-Competition only, the Athlete should apply for a TUE at least thirty (30) days before their next Competition, unless it is an emergency or exceptional situation.

A Therapeutic Use Exemption may protect athletes from receiving a sanction if a prohibited substance is found in their sample or advised by Sport Integrity Australia that they can (should) apply as a result of an investigation.

Do you need a Therapeutic Use Exemption?

Step 1

Check the substance on the Global DRO website to see if the substance or the method is prohibited.

Step 2

If the substance and/or method is prohibited and you need to use the substance, you now need to work out if you need an in-advance or retroactive Therapeutic Use Exemption.

NOTE: not all medications are eligible for a Therapeutic Use Exemption and having a Therapeutic Use Exemption will only guard against a possible anti-doping rule violation if the medication is used as per the Therapeutic Use Exemption.

Athletes who require the use of Testosterone are strongly encouraged to review the information required with their treating Practitioner before applying for a Therapeutic Use Exemption.

Preparing a medical file does not guarantee a Therapeutic Use Exemption will be granted.

Are you eligible for an in-advance Therapeutic Use Exemption?

Only certain, higher-level athletes need to apply for a Therapeutic Use Exemption in-advance. In-advance Therapeutic Use Exemptions need to be applied for before taking the medication (except for emergency situations and hospital visits). Other athletes are able to apply for a planned retroactive Therapeutic Use Exemption once they have been tested or advised by Sport Integrity Australia that they can (should) apply as a result of an investigation.

Check the list of sports and criteria for athletes needing an in-advance Therapeutic Use Exemption. If your sport is listed and you meet one or more of the criteria, you will need to apply for an in-advance Therapeutic Use Exemption.

If you have been notified by Sport Integrity Australia of your inclusion on the Sport Integrity Australia Registered Testing Pool/Domestic Testing Pool, you are required to apply for an in-advance Therapeutic Use Exemption irrespective if your sport is listed or not.

If your sport is not listed or you do not meet any of the criteria, you should prepare a medical file in case you need to apply for a planned retroactive Therapeutic Use Exemption in the future.

Note: On 1 January each year the details of sports and criteria requiring an in-advance Therapeutic Use Exemption is updated. Please ensure that you check your circumstances on or after 1 January.

Online tool: check if you need to apply for an in-advance TUE

Retroactive Therapeutic Use Exemption

Retroactive Therapeutic Use Exemptions may be approved for the following:

• Emergency or urgent treatment of a medical condition was necessary.
• There was insufficient time, opportunity or other exceptional circumstances that prevented the athlete from submitting (or the TUEC to consider) an application for the TUE prior to sample collection.
• Due to national-level prioritisation of certain sports, the athlete’s National Anti-Doping Organisation did not permit or require the athlete to apply for a prospective TUE.
• If an Anti-Doping Organisation chooses to collect a sample from an athlete who is not an International-Level Athlete or National-Level Athlete, and that athlete is using a Prohibited Substance or Prohibited Method for Therapeutic reasons, the Anti-Doping Organisation must permit the athlete to apply for a retroactive TUE.
• The athlete used Out-of-Competition, for Therapeutic reasons, a Prohibited Substance that is only prohibited In-Competition.

In rare and exceptional circumstances and notwithstanding any other provision in the ISTUE, you may apply for and be granted retroactive approval for a therapeutic use of a prohibited substance or method, if considering the purpose of the Code, it would be manifestly unfair not to grant a retroactive TUE.

Apply for a Therapeutic Use Exemption

STEP 1

Fill in the TUE form here:

Therapeutic Use Exemption application form [PDF]

STEP 2

Check the medical evidence to common Therapeutic Use Exemption applications, to see what specific medical information you need to provide.

STEP 3

Send the completed form and supporting medical information to:

• Post: PO Box 1744, Fyshwick ACT 2609
• Email: asdmac@sportintegrity.gov.au

NEED HELP?

If you need assistance with the Therapeutic Use Exemption application:

• Call: 02 6222 4283 or:
• Email: asdmac@sportintegrity.gov.au