In 2018, of the approximate 270,000 Canadians diagnosed with inflammatory bowel disease, 135,000 Canadians were living with Crohn’s disease (CD). With a total direct cost of about $1.28 billion in 2018, roughly 42% is allocated to prescription drug use for individuals with inflammatory bowel disease. As an incurable chronic disease with alternating periods of relapse and remission, CD is characterized by symptoms such as weight loss, diarrhea, and abdominal pain. To induce remission, conventional pharmacotherapy (e.g., corticosteroids, purine analogues, methotrexate) can be used. For patients with refractory CD, biologic therapy (e.g., tumour necrosis factor inhibitors [TNFi], non-TNFi biologics) are available. Furthermore, about 75% of individuals suffering from CD will undergo surgical resection at least once. However, postoperative endoscopic and clinical recurrence rates can be as high as 61% after 6 months and 86% after 5 years, respectively. The aforementioned pharmacotherapy options can be used to lengthen the duration of postoperative remission. Nonetheless, uncertainty remains regarding the comparative effectiveness of these pharmacotherapy interventions. Biologics such as TNFi (e.g., adalimumab [ADA], infliximab [IFX]) and non-TNFi (e.g., vedolizumab [VEDO], an anti-integrin) have been shown by randomized placebo controlled trials to be effective for individuals with moderate to severe CD that is refractory to conventional treatment options. Due to the scarcity of head-to-head trials comparing one biologic to another, the choice of first and second-line biologic therapy has been dependent on clinician experience, patient preference, and/or drug coverage. Public and private drug payers have implemented tiered coverage policies as a cost control measure. In cases where there is a lack of evidence that one option is more effective than another, these policies require patients to trial inexpensive alternatives first before applying for special authorization to use a higher cost option. The objective of this report is to review and summarize the relevant literature regarding the clinical effectiveness of ADA versus IFX or VEDO in adult patients with CD.