OBJECTIVES: Rituximab and infliximab are biologic disease modifying anti-rheumatic drugs (DMARDS) used to treat rheumatoid arthritis (RA). Rituximab is re-dosed when signs and symptoms return, but infliximab has fixed dosing intervals. This 3-centre observational study was to determine the secondary care resource and patient time implications of this difference. METHODS: Medical records of 44 patients with RA, treated with infliximab (n=26) or at least 2 courses of rituximab (n=18) were reviewed retrospectively to determine mean time between end of 1st rituximab course and start of the 2nd, and numbers of visits and investigations for both drugs. Staff and patient time required for drug administration was measured prospectively by direct observation of 25 patients receiving infliximab (n=13) or rituximab (n=12). RESULTS: Mean time between 1st and 2nd courses of rituximab was 43 weeks (range 15-84). During this time a mean of 6.9 (range 4-8) infliximab infusions was administered. Rituximab-treated patients required 2 visits for drug administration during this time, vs. infliximab 6.9 visits. Each visit required a mean of 87.2 minutes of staff time for rituximab patients vs. 46.0 minutes for infliximab. Total staff time per patient over 43 weeks  was 2.9 hours for rituximab vs. 5.3 hours for infliximab. Mean total patient time in the unit per 43 weeks was 14.1 hours for rituximab vs. 25.3 hours for infliximab. CONCLUSIONS: Although rituximab requires almost twice as much staff time per visit for its administration as infliximab, it is administered less often so staff time required over a whole course is less for rituximab than infliximab. An even greater difference was seen for patient time spent on the unit for drug administration. This study demonstrates benefits from rituximab in terms of patient convenience and staff efficiency, which can inform NHS planning of service delivery and quality standards for patients with RA.