This bill creates a comprehensive framework for reviewing and potentially regulating prescription drug pricing in Michigan through the establishment of two key entities: the Prescription Drug Affordability Board and the Prescription Drug Affordability Stakeholder Council. The board, composed of five members appointed by the governor with expertise in healthcare economics, policy, and clinical medicine, will have the authority to review prescription drug products that meet specific cost criteria, such as high wholesale acquisition costs or significant price increases. If the board determines that a drug creates affordability challenges, it can establish an upper payment limit for that drug, which prescription drug purchasers and third-party payers must then follow. The stakeholder council, which includes 21 members representing various stakeholders like manufacturers, healthcare providers, employers, and patient advocates, will assist the board in its decision-making process. The bill includes strict conflict-of-interest provisions to ensure board and council members remain unbiased, requires annual reporting to the legislature about drug pricing trends and review outcomes, and mandates a one-time comprehensive study on generic drug pricing. Importantly, the implementation of the act is subject to legislative appropriation, and the board is given the ability to create rules and seek additional assistance in carrying out its functions.