Observational studies have reported that response to infliximab is regained after the dose is increased, or dosing frequency is increased. A Canadian clinical practice guideline supports the practice of dose escalation in the event of loss of response. The CADTH HTA and current Canadian guidelines appear to be using the same studies to draw conclusions regarding the effectiveness of infliximab dose escalation in Crohn’s disease. The economic impact of infliximab dose escalation was not considered in the Canadian guidelines and this may be an issue for policy consideration since it could double drug costs. The limited information from controlled studies about infliximab dose escalation may be a consideration for decision-making.