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Doping and TUEs

Lost in the recent media blitz over the Floyd Landis case was an interesting and largely overlooked dimension to the doping controversy: the widespread granting of Therapeutic Use Exemptions (TUEs) to elite athletes for banned substances. One media report, stated that 60% of the riders tested for banned substances during the 2006 Tour de France had been granted TUEs.

So what in the heck is a TUE? According to the World Anti Doping Agency (WADA):

Athletes, like all others, may have illnesses or conditions that require them to take particular medications. If the medication an athlete is required to take to treat an illness or condition happens to fall under the Prohibited List, a Therapeutic Use Exemption may give that athlete the authorization to take the needed medicine.

If 60% of the 105 tested riders on the Tour de France had TUEs, and the sample of tested riders reflects the entire field, then professional bike racers must be a sickly lot. More than half of them have illnesses that require taking medications on the WADA Prohibited list - a list that includes only performance enhanching medications, not aspirin, Pepcid AC, or NyQuil. I wonder what percentage of the general population has a medical condition that requires treatment with one of the medicines on the WADA Prohibited List? If the general population uses medicines on this list in the same proportion as Tour de France riders, I need more pharmaceutical stocks in my 401(k).

Actually, I have an alternative explanation for the high incidence of illnesses in this particular population. Athletes clearly face incentives to use performance enhancing drugs. But it is also likely that the organizers of athletic contests like the outcomes generated by performance enhancing drugs; they produce extraordinary outcomes more often than would occur in an environment without performance enhancing drugs. These events generate more interest in the event and lead to higher profits.

But event organizers must trade off the benefits from the use of performance enhancing drugs, against the costs, which take the form of negative media attention because of the "tainted" product being produced and public outcry over the effect on young athletes, among other factors. One way to balance these conflicting consequences is to loudly proclaim strict enforcement of WADA regulations and hand out stiff penalties to violators, while quietly granting TUEs based on a relatively lax standard.