WHAT IS A THERAPEUTIC USE EXEMPTION (TUE)?

Athletes, like all people, may have illnesses or conditions that require them to take a particular medication/substance or undergo certain procedures/methods. 

If the substance or method appears on WADA’s List of Prohibited Substances and Methods, athletes must obtain a Therapeutic Use Exemption (TUE) in order to have the permission to take it or use it. 

TUEs can only be granted by Anti-Doping Organisations following a robust review process that is defined in WADA’s International Standard for Therapeutic Use Exemptions and involves evaluation by a panel of at least three physicians specialised in sports medicine and/or other relevant specialties.

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 30 days before his/her next competition, unless it is an emergency or exceptional situation.

Q: Who must obtain TUEs from JJIF?

The JJIF Anti-Doping Rules (JJIF ADR) require that all International-level Athletes* who need to take medication/treatment which is on WADA’s Prohibited List must submit a Therapeutic Use Exemption (TUE) application to JJIF as follows:

• If the Athlete does not already have a TUE granted by his/her National Anti-Doping Organisation (NADO), he/she must apply directly to JJIF.

• If the Athlete already has a TUE granted for national-level competitions by his/her NADO, that TUE is not automatically valid for international-level competition and it is possible to apply to JJIF for recognition, provided that such TUE decision has been  reported in accordance with Article 5.4 of the International Standard for Therapeutic  Use Exemptions and therefore is available for review by WADA.
  * International-level Athletes are defined in the JJIF ADR as reported below. 

Q: What are the criteria for granting a TUE?

The criteria are:

• The athlete would experience significant health problems without taking the prohibited substance or method;
• The therapeutic use of the substance would not produce significant enhancement of performance;
• There is no reasonable therapeutic alternative to the use of the otherwise prohibited substance or method;
• The requirement to use that substance or method is not due to the prior use of the substance or method without a TUE which was prohibited at the time of use.

For the TUE to be granted, all four criteria must be met.

Q: Which athletes are considered to be “International-Level Athletes”?

International-level athletes are defined as:

• Athletes with the following ranking in all categories: 1-10 in the JJIF World Ranking List, available on the JJIF website;
• Athletes who compete in the World Games and the World Championships;
• Athletes included in the JJIF Registered Testing Pool, Testing Pool and any other pool as established by JJIF.

Athletes who do not fall under the above-mentioned categories should submit TUE applications to their respective National Anti-Doping Agency (NADO).

Q: I am an International-Level Athlete. How and when should I apply to JJIF for a TUE?

• As soon as a new treatment is prescribed to you, you must check whether it involves prohibited substances or methods. If this is the case, a TUE application form (please see at the end of the page) must be completed, signed and sent to JJIF ([email protected]) by you or through your National Federation. In accordance with the JJIF ADR, TUE applications should be sent at least thirty (30) days before your next competition.
• TUE applications must be adequately documented with relevant medical records in order to be considered. According to the JJIF ADR, medical evidence confirming the diagnosis and explaining the reasons for the required treatment shall be transmitted along with the TUE application. The medical evidence must include a comprehensive medical history and the results of all relevant examinations, laboratory investigation and imaging studies. Please note that applications sent without medical evidence cannot be considered. Please refer your treating physician to the medical information available on WADA’s website to support the decisions of TUE committees. In case of doubts, contact [email protected]
• Once your application is received, JJIF may request additional information in order to document the clinical situation in accordance with WADA’s Standard for Therapeutic Use Exemptions. The JJIF TUE Committee has twenty-one (21) days to issue a decision once the full application (including sufficient medical documentation) is received. For this reason, you should send your TUE application at least 21 days prior to your next competition.
• If it is not possible for you to apply 30 days before the decision is needed, you must imperatively attest the urgent nature of the application in the form. JJIF tries to be as flexible as possible to accommodate these situations, however urgent applications should be exceptional, not routine.
• TUE applications cannot be considered for retroactive approval except in the cases mentioned in article 4.3 of the International Standard for Therapeutic Use Exemptions.

• Once a TUE is granted: (1) any change in substance, dosage, route of administration and/or frequency requires the submission of a new TUE application (ISTUE Art. 6.12); and (2) in case of persistence of the medical condition, it is the athlete’s responsibility to apply in advance for renewal of the present TUE prior to its expiry date.