The evidence-based medicine recommendations included in the Tertiary and Quaternary Essential Medicines List (EML) are reviewed through the transparent critical appraisal of global evidence, using a systematic evidence-to-decision framework. The Tertiary and Quaternary Hospital Level EML, which constitutes a list of essential medicines for approved indication, is ratified and distributed quarterly following NEMLC approval. It guides the selection, procurement and use of medicines at Tertiary and Quaternary level health establishments in the public sector in South Africa.

Medicine Review and Costing Analyses
A Medicine Review is the process whereby relevant clinical evidence on a specific medicine is gathered and analysed, with the findings presented in a Medicine Review Technical Report that is presented to the NEMLC for appraisal. A Medicine Review is conducted to determine if a medicine should be added or deleted from the EML for a specific indication.

Costing analyses compare the cost of two regiments or formulations. Aspects like costs of treatments and human resources are considered, and clearly state the assumptions made when conducting the analysis.