Therapeutic Use Exemptions (TUE)

What is a Therapeutic Use Exemption (TUE)?

Players may need medical treatment. In particular, they may have illnesses or health conditions that require them to take medications or undergo medical procedures. If the medication or method a player is required to use to treat or diagnose an illness or condition is prohibited as per the World Anti-Doping Agency’s (WADA) Prohibited List a TUE may give that player the authorization to use that substance or method while competing without leading to an anti-doping rule violation (ADRV) and applicable sanction.

Applications for TUEs are evaluated by a panel of physicians, the FIBA TUE Committee (TUEC). 

What are the criteria for granting a TUE?

All of the four following criteria must be met (for the full details of the criteria, please refer to the WADA International Standard for Therapeutic Use Exemptions (ISTUE) Article 4.2):

-  The player has a clear diagnosed medical condition which requires treatment using a prohibited substance or method;

-  The therapeutic use of the substance will not, on the balance of probabilities produce significant enhancement of performance beyond the player’s normal state of health;

- The prohibited substance or method is an indicated treatment for the medical condition, and there is no reasonable permitted therapeutic alternative;

-  The necessity to use that substance or method is not a consequence of the prior use (without a TUE), of a substance or method which was prohibited at the time of use.

Who should apply for a TUE?

Any player who needs to take a medication or use a treatment that falls under the WADA Prohibited List.

As a player, you have a responsibility to check ALL medications and treatments to make sure that they are not prohibited! 

How do I check if my medication or treatment is prohibited?

First, check if the required medication contains any substance that is prohibited as per the WADA Prohibited List, or if the method you intend to use is prohibited as per the WADA Prohibited List. Please note that the Prohibited List does not list brand names of medications, but their active ingredients. Therefore, even if you do not find the name of your medication on the Prohibited List, it may still contain a prohibited substance. To facilitate your search, you may use a ‘check your medication’ online tool or ask your NADO if it has one. However, the brand names of medications vary from one country to another, and you may not be able to find your medication in the online tool if you are using a medication that is not registered in the country for which the tool was designed.

You must inform your physician(s) that you are a Player bound to anti-doping rules. You and your physician(s) should check the Prohibited List for the substance/method you are prescribed. If the substance/method is prohibited, discuss non-prohibited alternatives, if there are none, apply for a TUE. 

IMPORTANT!! It is not enough to only ask a physician! You should always double-check on your own to make sure that your medication or treatment is not prohibited. You will not be excused from an anti-doping rule violation if you received bad advice from a doctor, coach, trainer or other third party.

Contact your NADO or FIBA if you are having difficulties.

Where to apply?

Players who are subject to anti-doping rules would need a TUE to take a prohibited substance or use a prohibited method.

If you are a player who is competing in FIBA Competitions you must file your TUE request with FIBA! Do NOT file an application first with your National Anti-Doping Organization, this TUE would not be recognized at a FIBA Competition and will likely cause a delay in the processing of your application.

FIBA Competitions include all FIBA National Team Competitions, FIBA Club Competitions, FIBA 3x3 Competitions and FIBA-Recognised Competitions or other competitions applying the FIBA anti-doping regulations by reference.

If you only compete in national championships, you must submit a TUE application directly to your National Anti-Doping Organization. Please click here to access a list of all NADOS.

When to apply?

If you compete in FIBA Competitions, you must apply to FIBA in advance, as soon as the need arises and prior to starting to use or possession of the prohibited substance or method, unless there are emergency or exceptional circumstances (see below on applying for a retroactive TUE).

For substances prohibited in-competition only, you should apply for a TUE as soon as the need arises, but at least 30 days before your next competition, unless one of the exceptions on retroactive TUEs (see below) apply.

Please refer to the section “How to apply to FIBA for a TUE?” below.

What if I already have a TUE from my National Anti-Doping Organization?

If you already have a TUE granted by your National Anti-Doping Organization (NADO):

If you want to compete in a FIBA Competition: Your NADO’s TUE is only valid at the national level, and you must submit a request for recognition to FIBA. Please refer to the section “How to submit a request for recognition of your NADO’s TUE to FIBA?” below.

If you are not competing in FIBA Competitions:

If you are NOT an International-Level Player and you have been tested by FIBA, FIBA recognizes a valid TUE granted by your NADO (i.e., it satisfies the ISTUE criteria for granting a TUE), following review by FIBA’s TUE Committee.

Can I receive a retroactive TUE?

A “retroactive” TUE grants permission retroactively for medical treatment that was administered before a valid TUE was in place.

You may only apply retroactively for a TUE in certain circumstances for the full details of the criteria, please refer to the WADA International Standard for Therapeutic Use Exemptions (ISTUE) Article 4.1):

-  You required emergency or urgent treatment of a medical condition.

-  There was insufficient time, opportunity or other exceptional circumstances that prevented you from submitting the TUE application or having it evaluated, before getting tested.

-  You are a lower-level player who is neither an international-level player nor a national-level player (as defined by FIBA or your NADO, respectively) and were tested.

-  You tested positive after using Out-of-Competition a substance that is only prohibited In-Competition (for example glucocorticoids).

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.

This unique retroactive TUE will only be granted with the prior approval of WADA (and WADA may in its absolute discretion agree with or reject the FIBA’s decision).

Important note:

Using a prohibited substance or method without a TUE could result in an Anti-Doping Rule Violation.

In cases where you are using a prohibited substance or method therapeutically and an application for a retroactive TUE would be  necessary following a sample collection, you are strongly advised to have a medical file prepared and ready to submit for evaluation.

How to apply to FIBA for a TUE?

Please download the FIBA’s TUE Application Form here, and once duly completed and signed, submit as per the instructions on the form (see the very last page).

Your TUE application must be submitted in legible capital letters or, preferably, typing.

The medical file must include:

-  A comprehensive medical history, including documentation from the original diagnosing physician(s) (where possible);

-  The results of all examinations, laboratory investigations and imaging studies relevant to the application.

Any TUE 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 physician in providing the correct medical documentation, we suggest consulting the WADA’s Checklists for TUE applications for guidance and support, and Medical Information to Support the Decisions of TUECs for guidance on specific common medical conditions, treatments, substances, etc.

Keep a complete copy of the TUE application form and all medical information submitted in support of your application, and proof that it has been sent.

How to submit a request for recognition of my NADO’s TUE to FIBA.

Your request for recognition should be submitted to FIBA in writing, quoting your ADAMS TUE reference number.

Keep a complete copy of your application and proof that your request for recognition has been sent to FIBA.

What happens at major events?

A Major Event Organization (MEO) requires players to apply for the recognition of their TUE if they wish to use a prohibited substance or method in connection with the Event.

If you have a TUE granted by FIBA and you will be competing at a Major Event e.g., the Olympic Games, you should contact the MEO for information on their recognition process.

When will I receive a decision on my TUE application or request for TUE recognition?

FIBA’s TUEC’s will render a decision as soon as possible, and usually within 21 days from the date of receipt of the complete TUE application [or request for recognition].

What if I need to renew my TUE?

Each TUE has a specific duration, at the end of which it expires automatically. Should you need to continue to use the prohibited substance or method, it is your responsibility to submit a new application for a TUE with updated medical information ahead of the expiry date, so that there is sufficient time for a decision to be made prior to the expiry of the current TUE.

Important note:

The presence (following sample collection), use, possession or administration of the prohibited substance or method must be consistent with the terms of your TUE. Therefore, if you require a materially different dosage, frequency, route or duration of administration, you should contact FIBA, as you may be required to apply for a new TUE. Some substances and dosages, e.g. insulin, are often modified during treatment and these possible fluctuations should be mentioned by the treating physician in the TUE application and would usually be accepted by the ADO TUEC.

What if my TUE application to FIBA is denied?

A decision to deny a TUE application will include a written explanation of the reason(s) for the denial. If it is not clear to you, please contact FIBA to understand exactly why the TUE was denied. Sometimes, there may be a critical piece of information, diagnostic test, laboratory results missing, etc. In which case, you should re-apply to FIBA so that the TUEC can reassess your case.

If none of the above applies, you and/or your NADO may refer the matter to WADA for review no later than 21 days after notification of the FIBA TUEC decision. You should send the same information that you submitted to us, and on which the decision to deny the TUE was based, via a secure online method or by registered mail at:

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 and/or send the request for review is: medical@wada-ama.org

It should be noted that WADA is not obliged to proceed with a request for a review. In that case, you and/or your NADO may appeal to the Court of Arbitration for Sport (CAS).

What if my NADO’s TUE is not recognized by FIBA?

You and/or your NADO have 21 days from the date of the decision to refer the matter to WADA for review.  The email address to enquire and/or send the request for review is: medical@wada-ama.org. Alternatively, you may send to:

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 same information that was provided to your NADO should be submitted to WADA.  Please use a secure online method unless sending by registered mail.

Pending WADA’s decision, your NADO TUE remains valid for national-level competition and out-of-competition testing only.

If the matter is not referred to WADA for review, your NADO must determine whether the original TUE that was granted should remain valid for national-level Competition and Out-of-Competition Testing.

Will my medical information be treated in a confidential manner?

All the information contained in a TUE application, including the supporting medical information and any other information related to the evaluation of your TUE request, is kept strictly confidential and treated in accordance with the Player’s Declaration contained in the ADAMS TUE process and in the FIBA’s TUE Application Form hereAll members of the TUEC and any other authorized recipients of your TUE request and related information (as described in the Player’s Declaration) are subject to a professional or contractual confidentiality obligation.

Please review the terms of the Player’s Declaration carefully. In particular, note that should you wish to revoke the right of the FIBA’s TUEC to obtain the information related to your TUE in accordance with the Player’s Declaration, your TUE application will be deemed withdrawn without approval [or recognition] being granted.

Your TUE request-related information will be retained by FIBA and any other authorized recipients for no longer than necessary for the purposes stated in the Player’s Declaration, in accordance with the WADA International Standard for the Protection of Privacy and Personal Information. 

Contact information

For any further information and questions in relation to FIBA’s personal information practices, please contact FIBA’s DPO as set forth on FIBA’s privacy policy.

If you have a doubt as regards to which organization you should apply for a TUE, or as to the recognition process, or any other question about TUEs, please contact FIBA at maildoping@fiba.basketball.

Other useful links: 

WADA International Standard for Therapeutic Use Exemptions (ISTUE)

WADA Q&A on Therapeutic Use Exemptions

WADA Checklists for TUE Applications

WADA Guidelines for the 2021 International Standard for Therapeutic Use Exemptions (ISTUE)  

WADA Anti-Doping Education and Learning (ADEL)