The proposed "Prescription Drug Cost and Affordability Review Act" aims to establish a comprehensive framework for evaluating the costs and affordability of prescription drugs in Michigan. It creates a Prescription Drug Affordability Board, composed of five governor-appointed members with expertise in health care economics and clinical medicine, and a Prescription Drug Affordability Stakeholder Council with 21 representatives from various sectors, including manufacturers, insurers, and patient advocates. The bill sets criteria for selecting high-cost drugs for review and allows the board to establish upper payment limits for these drugs if they pose affordability challenges. It also emphasizes transparency by adhering to open meetings and freedom of information laws while prohibiting discriminatory cost-effectiveness measures based on health status or age.

Additionally, the bill mandates that the upper payment limits for prescription drugs take effect no sooner than six months after being established by the board, and it prohibits purchasers from exceeding these limits. The attorney general is empowered to investigate violations and enforce compliance. A Prescription Drug Affordability Fund will be created to support the board's activities, and the board is required to submit an annual report to the legislature on price trends and recommendations. Furthermore, the board will conduct a one-time study on generic drug pricing and its impact on insurance and Medicaid spending, with the authority to promulgate rules and enter contracts for effective implementation.