The "Prescription Drug Cost and Affordability Review Act" aims to enhance the affordability and accessibility of prescription medications in Michigan by establishing a Prescription Drug Affordability Board and a Stakeholder Council. The Board will select prescription drugs for review based on criteria such as high acquisition costs or significant price increases, and will conduct comprehensive reviews considering factors like manufacturer pricing strategies and patient access. The legislation allows the Board to set upper payment limits for drugs that pose affordability challenges, ensuring transparency and accountability through compliance with open meetings and freedom of information laws. Additionally, it includes provisions to prevent conflicts of interest among Board and Council members.

The bill also mandates cost-effectiveness analyses for drugs that extend life, requiring evaluations to be impartial regardless of an individual's health status or age. It establishes a Prescription Drug Affordability Fund to support the Board's operations and mandates annual reports to the legislature on price trends and recommendations. The Attorney General is granted the authority to investigate violations and pursue civil action against offenders. The implementation of the act is contingent upon appropriations, and the Board is empowered to create necessary rules and contracts for its execution.