The "Prescription Drug Cost and Affordability Review Act" aims to create a structured approach to assess the costs and affordability of specific prescription drugs in Michigan. It establishes a Prescription Drug Affordability Board and a Prescription Drug Affordability Stakeholder Council, which will have designated roles in selecting drugs for review based on criteria such as high acquisition costs or significant price increases. The Board will conduct comprehensive reviews that take into account manufacturer pricing strategies and patient access issues, and it will have the authority to set upper payment limits for drugs that pose affordability challenges.

Additionally, the bill mandates that the Board evaluate the value of life-extending drugs without bias towards an individual's health status, age, or disabilities. It also creates a Prescription Drug Affordability Fund to support the Board's operations and requires annual reports to the legislature on price trends and drug reviews. The Attorney General is empowered to investigate violations and pursue civil actions against offenders. The implementation of the act is dependent on appropriations, and the Board is authorized to create rules and contracts to carry out its responsibilities effectively.