The "Prescription Drug Cost and Affordability Review Act" aims to tackle the escalating costs of prescription drugs in Michigan by establishing a Prescription Drug Affordability Board and a Prescription Drug Affordability Stakeholder Council. The board will conduct reviews of selected prescription drugs that pose affordability challenges, focusing on those with high acquisition costs and significant price increases. It will have the authority to set upper payment limits for certain drugs, ensuring that costs remain manageable for consumers and healthcare providers. The bill emphasizes transparency by requiring the board to operate under open meeting laws and to make certain documents public while protecting proprietary information. Importantly, the upper payment limits will not include professional dispensing fees and will not apply to drugs currently in shortage.

The legislation also establishes a Prescription Drug Affordability Fund to support the board and cover implementation costs. Once the upper payment limits are set, purchasers and third-party payers cannot buy or reimburse for drugs above these limits, with specific entities mandated to be reimbursed at or above the established limits. The attorney general is empowered to investigate violations and pursue civil actions for enforcement. Additionally, the board must submit an annual report to the legislature on price trends and conduct a one-time study on generic drug pricing and its implications for insurance and Medicaid spending. The board is also authorized to promulgate rules and enter contracts to facilitate the act's implementation, contingent upon appropriation.