S.F. 168 prohibits a manufacturer from imposing or causing to be imposed an excessive price increase on the sale of any generic or off-patent drug sold, dispensed, or delivered to any Minnesota consumer. The bill requires the commissioner of health to notify the manufacturer, attorney general, and Board of Pharmacy of any suspected violation of this prohibition. The attorney general is authorized to investigate possible violations and courts may issue orders enjoining manufacturers from continued violations, mandating repayment to Minnesota consumers and third-party payers, and imposing additional civil penalties. S.F. 168 further prohibits a manufacturer from withdrawing a drug from sale in the state, without providing 90 days advance notice, to avoid the prohibition on excessive price increases. This bill also establishes the Prescription Drug Affordability Board and the Prescription Drug Affordability Advisory Council to review the cost of prescription drugs, represent stakeholder views, and set upper payment limits for drugs. S.F. 168 allows the board to conduct drug cost reviews for specific drugs that meet certain pricing criteria. If the board determines which determination shall include consideration of public requests for the board to proceed with such reviews that spending on a drug product creates an affordability challenge, the board must set an upper payment limit for the drug. Failures of entities to comply with these payment levels and related requirements are subject to action by the attorney general seeking civil and/or criminal remedies. S.F. 168 further provides that violations of the prohibition against excessive price increases constitute grounds for disciplinary action against a manufacturer’s license, which may subject the entity to civil penalties. The bill also appropriates money in fiscal years 2024 and 2025.