Capitalised terms in this Q&A shall bear the meaning ascribed to them in the Tennis Anti-Doping Programme or at the first point they are mentioned in these Q&A
What is a Therapeutic Use Exemption (TUE)?
Tennis players, like all other people, may have illnesses or conditions that require them to take medications. If the medication a player is required to take contains a substance, or involves a method, that is on the Prohibited List, a TUE may be granted that enables that athlete to use that medication without committing an anti-doping rule violation under the Tennis Anti-Doping Programme.
Do I need a TUE?
Players are solely responsible for all substances that they ingest, including all medicines they take. Thus, it is crucial that all medication (and other products) are checked for prohibited substances. Several resources exist, such as the email help line offered by the Tennis Anti-Doping Programme, which is dedicated to such enquiries (firstname.lastname@example.org) and Global Drug Reference Online (www.globaldro.com). Other resources may be found on the ITF website (www.itftennis.com/antidoping).
What are the criteria for granting a TUE?
The criteria are:
The prohibited substance or method in question is needed to treat an acute or chronic medical condition, such that the athlete would experience a significant health problem if the prohibited substance or method were to be withheld;
The therapeutic use of the prohibited substance or prohibited method is highly unlikely to produce any additional enhancement of performance beyond what might be anticipated by a return to the Player’s normal state of health following the treatment of the acute or chronic medical condition;
There is no reasonable therapeutic alternative to the use of the prohibited substance or method.
The necessity for the use of the prohibited substance or prohibited method is not a consequence, wholly or in part, of the prior Use (without a TUE) of a substance or method which was prohibited at the time of such Use.
All four criteria must be met for a TUE to be granted.
Who grants TUEs?
The Tennis Anti-Doping Programme uses an independent Therapeutic Use Exemption Committee (TUEC), which consists of independent experts in clinical sports and exercise medicine. The TUEC is responsible for reviewing all requests for TUEs from players who wish to play in an event covered under the Tennis Anti-Doping Programme.
How do I apply for a TUE?
The player must download a TUE application form (see below), have their physician fill out the form, attach the required supporting documentation and send it to the IDTM Drug Information Centre (IDIC):
Telephone: +46 8 555 109 99
Fax: +46 8 555 109 95
Applications that are not filled in correctly will be returned to the player and not considered by the TUEC until the errors and/or omissions are corrected. Players should keep a copy of the application, and a record of the transmission or acknowledgement of receipt.
Where do I find the forms for TUEs?
All TUE forms can be found on the ITF website: http://www.itftennis.com/antidoping/tue
How long does an application take to process?
The average time for a decision is four days from the receipt of a fully-completed application, although this may take significantly longer, depending on the nature of the application. If a response has not been received after four days, players may contact IDIC to establish the status of their application. Where possible, players should submit TUE applications at least 30 days before they wish to use the medication in question.
Will the information on my TUE application remain confidential?
All information contained in a TUE application will be kept strictly confidential. All members of the TUEC are required to sign confidentiality agreements.
Can the decision of the TUEC be overturned?
All TUE decisions are subject to review by the World Anti-Doping Agency (WADA), whose own TUEC may reverse any decision. Conversely, a player whose TUE application is denied by the TUEC can request the WADA TUEC to review that decision (at their own expense). A TUE application that is denied by WADA can be appealed to the Court of Arbitration for Sport for a final decision.
When can I start using the medication and how long for?
TUEs are effective from the date specified on the Certificate of Approval. Players should not assume that their application will be granted, even for the renewal of an existing TUE. Any player who uses a Prohibited Substance prior to approval does so entirely at their own risk. All TUEs are granted for a specific period of time and so do expire. Before a TUE has expired, a new application must be submitted to permit continued use of the Prohibited Substance.
Can I get a back-dated TUE?
TUEs may be retroactively approved for any of the following reasons:
Emergency treatment or treatment of an acute medical condition;
Due to exceptional circumstances (including imminent competition), there was insufficient time or opportunity for the player to submit, or for the TUEC to consider, a TUE application prior to Sample collection;
The Player had not played in the qualifying draw or main draw of any Covered Event prior to the being tested;
The ITF and WADA agree that fairness requires a retroactive TUE to be granted.
The application form includes a space to describe such treatment or circumstances.
I have a TUE granted by my National Anti-Doping Organisation (NADO). Is this valid for events covered under the Tennis Anti-Doping Programme?
No. All TUEs granted by NADOs must be submitted to the TUEC for recognition. Players must send to IDTM: the application form that was completed for the TUE in question; the supporting medical information, and; the certificate issued by the NADO in question. These documents will be reviewed and, if the TUEC recognises the TUE, a new TUE will be granted in its place. If the TUEC does not recognise it, the player and his/her NADO will be notified, and will have 21 days to refer the matter to WADA for review. In such cases, the original TUE remains valid for use at national-level events. If it is not referred to WADA, the TUE automatically becomes invalid after the 21-day period expires.
What happens if the Prohibited Substance or method for which you have a valid TUE is detected during analysis?
When the report is received from the laboratory, an initial review will take place to verify that the substance is that for which a valid TUE exists, and that the results of the analysis are consistent with the conditions of that TUE. If this is the case, the no further action will be taken.
This summary should not be used as a substitute for a full review of the current TUE procedures, which all players applying for a TUE are strongly advised to do.