McKinsey Advised Purdue Pharma How to ‘Turbocharge’ Opioid Sales, Lawsuit Says

The world’s most prestigious management-consulting firm, McKinsey & Company, has been drawn into a national reckoning over who bears responsibility for the opioid crisis that has devastated families and communities across America.

In legal papers released in unredacted form on Thursday, the Massachusetts attorney general said McKinsey had helped the maker of OxyContin fan the flames of the opioid epidemic. McKinsey’s consultants, the attorney general revealed, had instructed the drug company, Purdue Pharma, on how to “turbocharge” sales of OxyContin, how to counter efforts by drug enforcement agents to reduce opioid use, and were part of a team that looked at how “to counter the emotional messages from mothers with teenagers that overdosed” on the drug.

The McKinsey disclosures are part of a lawsuit Massachusetts filed against Purdue Pharma, accusing the company of misleading doctors and patients about the safety of opioid use. Even when the company knew patients were addicted and dying, it still tried to boost sales of opioids, the lawsuit alleges, adding, “All the while, Purdue peddled falsehoods to keep patients away from safer alternatives.”

Purdue Pharma helped plant the seeds of the opioid epidemic through its aggressive marketing of OxyContin. More than 130 people die each day in the United States — 47,000 in 2017 — after overdosing on opioids, according to the National Institute on Drug Abuse.

As the death toll from opioid abuse has climbed, the cast of those who are alleged to have contributed to the crisis — manufacturers, distributors, doctors, pharmacists, hospitals and regulatory agencies — has grown. McKinsey is the newest and perhaps most surprising actor in this drama.

“From our initial review of the complaint, it appears that some of the references to McKinsey’s work lack context, including references to McKinsey that appear to be second- or third-hand,” McKinsey said in a statement, adding that it was continuing to review the document.

The suit, filed last year, names several Purdue executives and board members as well as members of the Sackler family, which controls the privately held company. McKinsey is mentioned 71 times in the 275-page complaint. The unredacted version was first reported by ProPublica and the medical news website Stat.

In 2009, McKinsey wrote a report for Purdue Pharma saying that new sales tactics would increase sales of OxyContin by $200 million to $400 million annually and “suggested sales ‘drivers’ based on the ideas that opioids reduce stress and make patients more optimistic and less isolated,” according to the lawsuit.

It was that year that Craig Landau, then Purdue’s chief medical officer and now its chief executive, had an email exchange that included a McKinsey consultant about how to counter mothers whose teenagers had overdosed on OxyContin. The solution: bring in patients to emphasize how the drug helps to relieve pain.

In 2013, amid the rapidly intensifying opioid crisis, the federal Drug Enforcement Administration and the Justice Department reached a settlement with Walgreens, the second-biggest American pharmacy chain. Walgreens agreed to new procedures to crack down on illegal prescriptions. In a report to Purdue Pharma, McKinsey said that “deep examination of Purdue’s available pharmacy purchasing data shows that Walgreens has reduced its units by 18%.”

According to the lawsuit, McKinsey recommended that Purdue “lobby Walgreens’ leaders to loosen up.”

McKinsey also recommended that Purdue redirect its sales force to focus on doctors who were especially prolific prescribers of OxyContin, according to the suit. One slide made public by the attorney general’s office, attributed to McKinsey, focused on one doctor in the town of Wareham, Mass., who almost doubled his annual output of OxyContin prescriptions after a big increase in visits from Purdue sales representatives.

If doctors resisted, McKinsey recommended that Purdue employ “patient pushback,” getting patients to lobby for OxyContin, according to the suit.

In a statement, Purdue said that the Massachusetts attorney general’s office “offers little evidence to support its sweeping legal claims.” The company also said that the lawsuit mischaracterized McKinsey’s work with Purdue.

On a chat site where participants must have a McKinsey email address to register for the company’s discussion room, several expletive-laced expressions of outrage over the revelations of McKinsey’s work with Purdue were mixed with comments about the responsibility to serve the client’s bottom line within moral and ethical boundaries.

“Then, of course it’s ok to maximize shareholder value, seek profits!,” one person wrote. “But not at all costs, not at the cost of our moral values and our society’s well being.”

Another person’s post — like all 42 entries about Purdue and McKinsey posted by midday Friday, it was anonymous — reproduced a bullet point from McKinsey’s values statement stating that the company will “observe high ethical standards.”

That is the second bullet point printed on the framed poster listing McKinsey’s mission and values that graces the 21st-floor lobby of McKinsey’s home office in Midtown Manhattan. The first reads: “put client interests ahead of the Firm’s.”

In 2018, after it spent years advising Purdue Pharma on how to increase sales of OxyContin, McKinsey published a report titled: “Why we need bolder action to combat the opioid epidemic.”