What happens to an existing Therapeutic Use Exemption (TUE) on January 1, 2027?

KEY TAKEAWAYS:

When the 2027 World Anti-Doping Code and the updated standard for medical exemptions take effect on January 1, 2027, a TUE that was properly granted remains valid through its approved expiration date. A renewal application considered on or after January 1, 2027, will generally be assessed under the 2027 ISTUE and the applicable anti-doping organization’s implementing rules.

If you rely on a therapeutic use exemption to treat a medical condition, the 2027 World Anti-Doping Code raises a fair question: does the exemption you already hold survive the switch? For most athletes, the answer is yes. 

A therapeutic use exemption that was properly granted and still in force does not vanish on January 1, 2027. Under the World Anti-Doping Agency's transitional approach, it stays valid until its stated expiration date.

The date that matters is your exemption's own expiration date. If it lapses in 2027, your renewal will be judged under the new standard, not the old one. And because using a prohibited substance without valid authorization is still treated as an anti-doping rule violation, a gap in coverage carries real consequences. 

Below, our international anti-doping attorneys explain what stays the same, what changes, and what to do before the new Code takes effect.

What Actually Changes Under the 2027 Standard?

The updated International Standard for Therapeutic Use Exemptions is designed to reflect current medical practice and to focus on athlete health. Two changes stand out.

Updated Medical Criteria at Renewal

The 2027 criteria place less emphasis on proving that no reasonable permitted treatment exists and more emphasis on whether the prohibited treatment is medically necessary and supported by clinical evidence. The revised wording is intended to help ensure athletes can receive appropriate medical care without unnecessary delays. It is a welcome change for many athletes, including athletes who manage ADHD with stimulant medication.

A New Two-Month Sanction for Retroactive Cases

The 2027 Code introduces a fixed two-month period of ineligibility for an athlete who tests positive but can later establish that the use would have met the exemption criteria. This is more forgiving than the sanctions that could otherwise apply, but it is still a sanction, and it applies only if you can prove you would have qualified. It is not a substitute for holding a valid exemption before you compete. If you receive a positive result, knowing the steps to take after an adverse analytical finding can protect your position from the first day of the case.

Will Your Exemption Still Be Recognized Across Sports and Levels?

Recognition rules continue under the new Code. If you hold an exemption from your national anti-doping organization, your international federation must recognize it as long as it meets the international standard. The moment recognition tends to matter most is when your competitive status changes, such as when you move up to the international level or switch federations. 

If your international federation refuses to recognize your TUE, you may have only 21 days to ask WADA to review that decision. Because the deadline and review process can vary depending on the type of decision, read the decision carefully and seek advice as soon as possible.

What Athletes Should Do Before January 1, 2027?

A little planning now prevents an accidental gap in coverage later. Before the new Code takes effect, it is worth working through the following:

• Confirm the exact expiration date of every exemption you hold, and note which ones lapse in 2027. 
• Plan for each renewal well ahead of its deadline so a new application is reviewed under the 2027 standard without a lapse. 
• Keep your medical file current, with up-to-date records and a treating physician’s support for the diagnosis and treatment. 
• Confirm which body has jurisdiction over your exemption, your international federation or your national anti-doping organization, as your level of competition changes. 
• Watch for updated application forms and procedures, which anti-doping organizations often revise when a new standard arrives.