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 be responsible for 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. The bill emphasizes transparency by mandating compliance with open meetings and freedom of information laws while safeguarding proprietary information.

Additionally, the legislation allows the board to set upper payment limits for certain drugs deemed unaffordable, ensuring that these limits cannot be exceeded by purchasers or third-party payers. It also empowers the attorney general to investigate violations and pursue civil actions against offenders. A Prescription Drug Affordability Fund will be established to support the board's operations, and the board is required to submit annual reports to the legislature on price trends and recommendations for enhancing drug affordability. The bill includes a provision for a one-time study on generic drug pricing and its effects on insurance and Medicaid spending, and it grants the board the authority to create rules and contracts necessary for the act's implementation.