<![CDATA[Introduction: Down-scheduling medicine policies aim to increase the availability of medicines by reclassifying certain prescription-only medicines to non-prescription classification. While these policies offer potential benefits, there is limited knowledge about the factors that enable or hinder their implementation.Methods: A systematic review of English language published literature from 2013-2024 was conducted. The literature was retrieved through web including PubMed, Scopus, Science Direct, Google Scholar, Cochrane, and Cinahl. The review focused on studies that explored the enablers and barriers to down-scheduling policies, with the keywords “drug reclassification" OR "medicine reclassification" OR "drug switching" OR "medicine switching" OR "drug down scheduling" OR "medicine down scheduling" OR "Rx-to-OTC".Results: A total of twenty-two eligible studies were identified. The analysis revealed that supportive policymakers, clear and transparent regulatory frameworks, positive perceptions of pharmacists, increased consumer awareness, and support from medical professionals are key enablers of successful down-scheduling policies. Conversely, risk-averse regulators and pharmacists' lack of confidence in self-medication emerged as significant barriers.Conclusion: Down-scheduling has been progressively implemented worldwide, enhancing consumer access to medicines and encouraging self-care. Nevertheless, regulatory challenges and concerns about safety and misuse continue to impede the broader adoption of such policies. Continuous evaluation, training, and regulatory clarity are essential for optimizing the benefits of down-scheduling policy. ]]>
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