These powerful but little-known companies that have been blamed for high drug prices are now coming out of the shadows for a congressional interrogation

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The US has a high drug prices problem. These obscure but powerful companies will now face some tough questions on Capitol Hill.

That's more than last year, when the prices of roughly 2,550 drugs were increased. But this time, the price hikes seem to have been more spread out, with drugmakers waiting"until March instead of January, to avoid scrutiny," said Michael Rea, the founder and CEO of Rx Savings Solutions.

It appears that"drug companies were much more conscientious about their tactics to raise prices this year," Rea said. These calculations are based on the"list price" of a drug, which a drug company gets to decide. The backlash about high drug prices has been focused on drugmakers because, at the end of the day, prices are their purview.

But PBMs also get involved in pricing, playing different drug companies against eachother to negotiate, because bigger and bigger discounts force them to hike prices, and so on.As PBMs have been blamed for the US drug price problem, the face of the PBM industry has been changing. PBMs are increasingly now in-house, folded into the larger corporate machinery of health insurers or even pharmacy chains. So that's who you'll see before the Senate Finance committee on Tuesday.

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