Infliximab has recently been approved for use in paediatric patients with severe active Crohn’s disease (CD) and is the only biologic licensed in this patient population. OBJECTIVES: To estimate the cost effectiveness of scheduled maintenance treatment with infliximab among children suffering from severe active CD in Scotland. METHODS: A Markov model was constructed to simulate the progression of a hypothetical cohort of CD children through predefined health states on scheduled maintenance treatment with infliximab (5 mg/kg) based on Targan, ACCENT I and REACH trials. The health states used in the model were remission, therapy (infliximab) responsive active disease, non-responsive active disease, surgery, post surgery remission and post surgery complications. Standard care, comprising immunomodulators and/or corticosteroids was used as a comparator. The primary outcome was quality adjusted life years (QALYs) estimated using EQ-5D from a European CD population. An average patient weight of 40 kg was used to estimate the dose of infliximab. The costs and outcomes were discounted at 3.5% over a period of 5 years. Stochastic sensitivity analyses were performed by varying the infliximab efficacy estimates, costs and utilities. RESULTS: The incremental cost effectiveness ratio (ICER) for scheduled maintenance treatment with infliximab was £12,483 for severe active CD children in Scotland. The sensitivity analyses revealed the analysis time horizon and efficacy estimates to be the most influential parameters with ICERs ranging from £5,348-£25,950. CONCLUSIONS: Scheduled maintenance treatment with infliximab (5mg/kg) is a cost effective treatment option for children suffering from severe active CD under an 8-week scheduled maintenance programme in Scotland.