I'm in the UK and have been on infliximab nearly 5 years now.
Basically the Dr's have to apply to the 'primary care trust' of that district as infliximab is expensive. The Dr needs to get evidence that the crohns is active, moderate/severe and other medication options have been exhausted. They will then put together a 'case file' with evidence of this, which may include blood test results, colonoscopy results, evidence that other drugs have failed then they send it to the PCT who will review it, and basically say yes or no. For me this process took around 2 weeks, although I think I remember the Dr saying it may take up to 6/8 weeks.
Re: TB screening that happened for me on the day my first infusion was scheduled (infusions happen in a hospital outpatient treatment unit), it basically consists of a chest X-Ray. Then if alls well you will get weighed and your weight will be sent to pharmacy so they can mix up the correct amount of infliximab. You get a canula put in then have pre-meds (IV anti-hystimine, IV steriod injection - if you get this ask for it to be diluted in a bag rather than a syringe as less side effects that way). These pre-meds help guard against minor allergic reactions to the infliximab. Your actual infliximab infusion usually takes around 2 hours, then you will be given a bag of saline which takes around 20 mins to go through. After your reaction you may have to stick around for about 2 hours to be monitored for reactions. Then all being well you'll be free to leave
The whole process takes around 8 hours for the first time. I had mine today and I can be 'infused' over 1 hour and don't have to wait around after so it takes around 4 hours total. I would advise bringing a book/magazines/snacks/water/phone/charger.
When you initially start infliximab you are usually given 3 doses in 6 weeks, then after that infusions are usually 8 weekly.
Hope this helps
Feel free to message me if you have any q's!
