OBJECTIVES: Limited information exists on real-world patient adherence to the FDA recommended prescribing schedules for adalimumab (ADA) (40 mg bi-weekly), etanercept (ETA) (50 mg/week), and infliximab (IFX) (every 8 or 4 weeks following induction) in the treatment of patients with rheumatoid arthritis (RA).  This study evaluates the days between infusions for IFX and refills for ADA and ETA. METHODS: Data between 01/2004-12/2007 were extracted from a retrospective multi-source claims database.  Inclusion criteria were aged ≥18, ≥2 diagnoses of RA (ICD-9 code 714.xx), ≥1 claim for biologic therapy, absence of any biologic claim for 12 months prior to index date, and absence of any biologic claim other than the index biologic for ≥730 days post-index date.  Patients with diagnoses of other selected inflammatory disorders were excluded. IFX patients were required to have ≥4 doses. Days between infusions or re-fills for the first 12 infusions of IFX and fills of ADA and ETA are reported.  Time to re-fill was calculated as the difference between fill dates minus days supply. RESULTS: Intervals between IFX infusions during the maintenance period ranged from a mean of 52.3 to 55.0 days over the first 12 infusions. Refills for ADA ranged from a mean of 7.3 to 11.4 days beyond recommended refill schedule over the first 12 prescription fills.  Refills for ETA ranged from a mean of 6.7 to 14.2 days beyond the recommended refill schedule.  CONCLUSIONS: Data from real-world community practice indicate that patients treated with IFX are infused at intervals consistent with prescribing information and patients undergoing treatment with ADA and ETA are refilling prescriptions one to two weeks later than the recommended refill schedule.  Further studies are warranted to understand the clinical implications of gaps in therapy with the more frequently dosed subcutaneous agents vs. the less frequently dosed infused medications such as IFX.