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Efforts to reduce low-value care often focus on interventions targeting the physician or the patient, such as education, decision-support tools or patient education. However, these interventions risk being ineffective if they fail to address the broader system-level factors that may be more powerful in influencing medial decision-making. With system-level factors we refer to the overarching components and structures within health systems that shape the delivery, organization, and financing of health services. Examples include incentives (e.g. fee-for-service reimbursement models), policies, guidelines, health care delivery structures, or regulatory frameworks. Achieving lasting change in reducing low-value care, requires a deeper understanding of, and a targeted action to address these system-level factors.In this workshop we will discuss system-level factors that drive low-value care and how they can undermine the effect of interventions aimed at reducing low-value care at the patient and provider levels. By sharing ongoing work of the European Health Observatory on this topic and case examples from different countries, participants gain insights into relevant system-level factors across different healthcare systems and examples of interventions on system level to reduce low-value care. The aim of the workshop is to inspire participants by providing new perspectives and ideas on how to address system-level factors and encouraging collaboration to tackle the challenges of reducing low-value care.The workshop is structured into three parts:Introduction with theoretical background on how to enable cross-country learning and methodological challenges in assessing system-level factors of low-value careCase examples on system-level factors driving low-value care, drawing on (deimplementation) examples from the Netherlands, Germany, the UK and Sweden.Interactive discussion to identify key research gaps and collaboratively outline a research agenda to strengthen the evidence base on system-level drivers of overuse.By the end of the workshop, participants will have a deeper understanding of how system-level factors drive overuse and influence individual decision-making. They will be able to critically discuss the relative importance of these factors compared to physician- or patient-level interventions in reducing low-value care. Through cross-country learning, participants will explore best practices from diverse healthcare systems, including those of the Netherlands, Germany, Sweden and the UK. Additionally, they will identify key research gaps and collaboratively outline a research agenda to strengthen the evidence base on system-level drivers of overuse. Furthermore, the workshop will provide a platform for networking and exploring opportunities for cross-country collaborations, including the development of potential funding proposals. As an outcome, we aim to prepare a discussion paper summarizing the workshop’s findings and discussions.