Healthcare policymakers rarely have the luxury of perfect information. They are often asked to make consequential decisions affecting the entire healthcare system while competing interests and sources of information all pull them in different directions. In those moments, the most important responsibility is not to reach the fastest conclusion. It is to follow the evidence.

That principle is especially important in the debate over vertical integration in healthcare, specifically regarding the common ownership of insurers, pharmacy benefit managers and pharmacies. Critics argue that these arrangements increase drug costs and reduce competition. Those concerns deserve serious consideration.

Before lawmakers pursue sweeping restrictions or forced divestitures, it is worth asking a simple question: What does the evidence actually show?

A recent review by the Department of Health and Human Services Office of Inspector General offers important insight. The report examined Medicare Part D plans and analyzed how vertically integrated organizations performed compared with organizations that do not share common ownership among insurers, pharmacy benefit managers and pharmacies. The findings are more nuanced than many participants in this debate might expect.

For the 60 drugs studied, the Office of Inspector General found that net drug costs were remarkably similar between vertically integrated organizations and other plan sponsors. Overall differences were less than 1 percent, regardless of whether it was brand-only drugs or multiple-source drugs. In short, the federal review did not find evidence that vertical integration was associated with materially higher net drug costs.

The report also found that vertically integrated plans generally offered lower monthly premiums. Medicare Advantage prescription drug plans sponsored by vertically integrated organizations had premiums that were half those of other plans, while standalone prescription drug plans also showed substantially lower premiums. And while the Office of Inspector General noted that some enrollees faced higher out-of-pocket costs for some drugs in the study period, recent Part D reforms are already designed to address that concern, including changes that cap enrollee costs and shift pharmacy price concessions to the point of sale.

Finally, the review examined claims that vertically integrated organizations systematically favor their own pharmacies. Here again, the findings were not consistent with the broad criticisms. The Office of Inspector General found that affiliated pharmacies were reimbursed slightly less at the point of sale than unaffiliated pharmacies for the drugs studied. Both groups generally received reimbursement above acquisition costs.

None of this means the healthcare system is perfect.

The report cautioned that additional information and audits may provide a more complete picture over time, but the available data does not support simple conclusions about pharmacy benefit managers and costs to consumers. Drug pricing remains a serious concern. Independent pharmacies face legitimate challenges in many communities, particularly in rural areas. Policymakers should continue pursuing transparency, accountability and competition throughout the healthcare system.

However, public policy should be based on demonstrated outcomes rather than assumptions about business structures. The mere existence of vertical integration does not, by itself, establish consumer harm. If lawmakers are going to mandate major changes to how healthcare organizations operate, the burden should be on demonstrating that those changes will improve affordability, access and patient outcomes.

That question is particularly important as state and federal policymakers consider legislation that would ban common ownership between pharmacy benefit managers and pharmacies. Not only have the constitutionality of these laws at the state level been called into question, but there is the potential for significant negative effects on pharmacy access and specialty pharmacy care if such broad structural changes are implemented. Healthcare is full of examples of well-intentioned reforms that produced unintended consequences.

Before pursuing major structural changes to the healthcare marketplace, lawmakers should ensure that the evidence supports the remedy. There is an important difference between identifying a problem and proving that a particular solution will solve it. Patients are best served when policy decisions are grounded in facts, careful analysis and a clear understanding of potential consequences.

The current push to divest common ownership between pharmacy benefit managers and pharmacies assumes that vertical integration is the root cause of many challenges facing the prescription drug market. Yet, the Inspector General’s review suggests the reality is far more complicated. If the evidence does not clearly establish that the structure itself is driving higher costs, policymakers should be wary of dismantling existing arrangements before fully understanding what may be lost in the process.

Gary D. Alexander served as Pennsylvania’s secretary of Human Services and Rhode Island’s secretary of Health and Human Services and Medicaid Director. He wrote this for InsideSources.com.