OBJECTIVES: To analyses the policies implemented for the pricing, promotion and classification of over-the-counter (OTC) drugs, in several European countries and to compare them with those in Greece. METHODS: The study presents in detail the structure of the prescription drug (Rx) and OTC market and the prevailing corresponding policies in 23 European countries. The data used in the study were mainly derived from the published literature and were synthesized and categorized with emphasis on the classification process, pricing, reimbursement and promotion of Rx and OTC. The above process was used to reveal and highlight commonalities and differences between the countries. RESULTS: It was found that the great majority of European countries apply free pricing for OTC drugs and only few countries choose state intervention. The 21 out of the 23 countries allow the OTC market to self regulate through the mechanisms of the market and competition and the main exclusion is Greece, which is one of the two countries, from those examined, which the government regulates the prices of OTC drugs. This policy initially was intended to protect consumers from excessive pricing and overconsumption of widely used drugs but has opposite results. In terms of the content, the analysis indicates that the positive and negative lists are wider in the case of Greece and the OTC list is narrower compared with the remaining countries. CONCLUSIONS: International experience indicates that the OTC list in Greece is narrower and heavily regulated in terms of price relative to other countries. This may lead to opposite results that those intended by budget holders. Careful expansion of the OTC list along with release of their prices, may lead to savings for the public spending and greater access to patients at reasonable cost and a patient level.