Replaces everything after the enacting clause. Creates the Prescription Drug Affordability Act. Defines terms. Establishes the Prescription Drug Affordability Board and provides that the Board's purpose is to protect State residents, State and local governments, commercial health plans, health care providers, pharmacies licensed in the State, and other stakeholders within the health care system from the high costs of prescription drug products. Contains other provisions about the Board, including: members of the Board; conflicts of interest; terms of members; the hiring of an executive director, general counsel, and staff for the Board; staff salary; meetings of the Board; and powers and duties of the Board. Creates the Prescription Drug Affordability Stakeholder Council with the purpose to provide stakeholder input to assist the Prescription Drug Affordability Board in making decisions as required under the Act. Contains other provisions about the Council, including: members of the Council; terms of members; and reimbursement of member travel expenses. Provides that the Board shall identify specified prescription drug products and determine whether each prescription drug product should be subject to a cost review. Provides that if the Board finds that spending on a prescription drug product has led or will lead to an affordability challenge, the Board shall establish an upper payment limit after considering: (i) the cost of administering the drug; (ii) the cost of delivering the drug to consumers; and (iii) other relevant administrative costs related to the drug. Includes provisions regarding remedies and an appeal process. Creates the Prescription Drug Affordability Fund to be used only to provide funding for the Board and for the purposes authorized under the Act. Provides that the Board shall submit a report to the General Assembly including specified information. Provides that the Board shall conduct a study of the operation of the generic drug market that includes specified information on or before June 1, 2023. Includes a provision on term expiration for Board and Council members. Makes conforming changes in the State Finance Act. Effective January 1, 2023.