The "Prescription Drug Cost and Affordability Review Act" establishes a framework in Michigan for reviewing the costs and affordability of certain prescription drugs. It creates a Prescription Drug Affordability Board and a Prescription Drug Affordability Stakeholder Council, which will have specific responsibilities, including selecting drugs for review based on criteria such as high acquisition costs or significant price increases. The board will conduct reviews to assess whether spending on these drugs creates affordability challenges for healthcare systems and patients. If necessary, the board can set upper payment limits for selected drugs, taking into account factors like administrative costs and healthcare access.

The bill also mandates that once an upper payment limit is established, purchasers and third-party payers cannot buy or reimburse for the drug above this limit, and certain entities must be reimbursed at or above the limit. It grants the attorney general the authority to investigate violations and enforce compliance. Additionally, a Prescription Drug Affordability Fund will be created to support the board's activities, which will include submitting annual reports to the legislature and conducting a study on generic drug pricing. The board will also have the power to promulgate rules and enter contracts to facilitate the act's implementation.