If your IBD team has said a biologic is the next step, or your current one is due and the date keeps slipping, it helps to know how to get biologics sooner: how these medicines are started, why waits happen, and where a private infusion clinic fits in.
What biologics are, and why some are given by infusion
Biologics are medicines made from living cells. Each one blocks a specific part of the immune response that drives the inflammation in Crohn’s disease and ulcerative colitis. Some are injections you give yourself at home. Others are given as a drip into a vein (an intravenous infusion) by a trained team, so you can be monitored while it runs.
- Infliximab (Remicade and its biosimilars) is given as an infusion, for both Crohn’s disease and ulcerative colitis.
- Vedolizumab (Entyvio) works mainly in the gut and is often given as an infusion, though an injectable form exists for maintenance.
- Ustekinumab (Stelara) starts with one infusion, and later doses are usually injections at home.
Treatment options have widened in recent years. Some biologics now come as an injection as well as an infusion, and newer medicines, including tablets such as JAK inhibitors, are used when biologics have not worked. Which suits you depends on your disease, your response so far and your preferences, and a specialist review is a good time to ask.
How biologics are started on the NHS
NICE guidance sets out when biologics are offered for Crohn’s disease and ulcerative colitis. In practice, they are usually considered when steroids and conventional treatments such as azathioprine have not controlled the disease, or cannot be used.
Before the first dose, your team screens you for infections such as tuberculosis and hepatitis, checks your vaccinations and bloods, and agrees the treatment plan with you. Infusions are then given in a hospital day unit or IBD infusion suite. Many injectable biologics are delivered to your home by a homecare service your hospital arranges, so you do not collect them from a pharmacy.
Why biologic treatment can be delayed
Delays rarely come from one place. The usual causes are the wait for a review to decide on treatment, time for screening results to come back, limited space in hospital infusion units, and funding approval where a trust requires it. For someone in a flare, each of those steps can feel like a long time.
Waits also happen once treatment is established: an infusion that cannot be booked on time, a move to a new area, or a trip abroad that clashes with a dose. Missing or delaying doses can make some biologics less effective over time, which is why timing matters.
Can you get biologics sooner privately?
Yes, and there are two quite different routes, depending on where you are with treatment.
- You are already on a biologic. A private clinic can give your infusion following the prescription and protocol from your gastroenterologist. This is useful when a dose would otherwise be late, or when you are away from home. See our private biologic infusions page for the medicines we give.
- You are not on a biologic yet. The first step is a specialist review to look at your history, current treatment and recent results, and whether a biologic is worth considering. Screening tests follow, and a gastroenterologist’s prescription is needed before treatment starts.
A biologic works best when it is given on time and monitored properly. Our job is to keep your treatment on schedule and make sure your own IBD team knows exactly what has been given and how you responded.
Kay Greveson, founder and advanced IBD nurse practitioner
What happens at a private infusion
Before your appointment, the clinic will ask for your diagnosis, the biologic and dose, your infusion schedule and treatment history, recent blood tests and infection screening, and details of any previous reactions. Sometimes an extra review or tests are needed first. You should receive a clear plan and the full price before anything is booked.
On the day, you are checked before the infusion starts, monitored while it runs, and observed for a period afterwards. A written summary then goes to you and your usual team, so your records stay complete.
Keeping your NHS team involved
Having an infusion privately does not mean leaving your NHS care. Most people keep their hospital team and use a private clinic to bridge a gap. Drug level tests, a blood test that shows whether your dose is high enough to keep working, are a good example of where both can share results. We arrange these as part of our tests and monitoring.
Kay helped establish the IBD biologics service at the Royal Free Hospital, and the team she leads works with biologic medicines every week. You can read about the team here.
Questions to ask a private infusion clinic
- Who gives the infusion, and how much experience do they have with IBD biologics?
- What information do you need from my gastroenterologist, and how soon can you book me in?
- Is the medicine included in the price, or charged separately?
- How am I monitored during and after the infusion?
- Will you send a summary and any results to my own IBD team?
If you are still deciding where to be seen, our guide on how to choose an IBD clinic or specialist covers the wider questions.
Your next step
If you are already on a biologic, message our IBD team with the medicine, your dose and when your next infusion is due, and we will tell you what we need and send a quotation. You can see our infusion prices first, and if you are travelling to London, our page for international patients explains how we plan around your dates.
If you are not on a biologic yet, start with a first appointment: a full review of your treatment so far and a written plan for what comes next.
