Consultancy firm McKinsey suggested its client, Purdue Pharma, pay rebates to distributors of OxyContin for every overdose case that could be traced to abuse of the opioid pill as part of its plan to “turbocharge” sales.

The suggestion was discovered by the New York Times in court documents, which were released last week under a Purdue Pharma bankruptcy process. Last month, the big pharma firm agreed to plead guilty to criminal charges involving its aggressive push of its dangerous product, which contributed to the opioid health crisis in the US.

It is reported that in a 2017 presentation, McKinsey laid out several suggestions for boosting sales of the pill, including by compensating distributors the damage from selling the product. It estimated the number of people who may overdose or get hooked on OxyContin and suggested paying rebates for “events” that could be reliably attributed to it.

For example, the report explains, a rebate of $14,810 for each of the 2,484 cases – which the consultancy firm projected would happen in 2019 due to OxyContin sold through CVS Health’s pharmacy chain – would net the distributor $36.8 million. CVS and another firm mentioned in the presentation, Anthem, are among McKinsey’s biggest clients. Both companies said they never received any rebates under a scheme described in the court papers.

McKinsey also, among several options, proposed that Purdue pay rebates for opioid overdoses or opioid use disorder cased by its product…not to the victims, but to the Pharmacy Benefits Managers like CVS and Anthem. See this slide (this is all from a court filing last week)

It is said that senior McKinsey partners also discussed in 2018 doing more than “eliminating all our documents and emails.” The suggestion was reportedly floated by Martin Elling, a leader for McKinsey’s North American pharmaceutical practice, in response to the news that the state of Massachusetts had sued a former Purdue board member for her role in fueling the opioid crisis. Elling’s addressee, Arnab Ghatak, responded as quoted: “Thanks for the heads up. Will do.” It’s not clear if any records were actually destroyed by McKinsey.

The email McKinsey senior partner Martin Elling sent to his colleague Arnab Ghatak on July 4, 2018.

The report also highlights McKinsey’s role in persuading the Sacklers family, who own Purdue, to accept their plan to “turbocharge” the sales of OxyContin and in preparing Purdue executives on how to push back against the US Food and Drug Administration.

The firm’s involvement in Purdue’s predatory business became public knowledge last year, after unredacted legal papers in the Massachusetts case were released. McKinsey has not been charged by the federal government or sued by anyone for consulting Purdue.

A pure definition of evil.

I think we will learn new evils about OxyContin and the people who made it for years to come

The New York Times story was met with disgust and anger online, with many commenters describing the money making advice as nothing short of “evil.” The same word was used by an expert cited by the newspaper.

“This is the banality of evil, M.B.A. edition,” Anand Giridharadas, a former McKinsey consultant who reviewed the documents, said of the firm’s work with Purdue. “They knew what was going on. And they found a way to look past it, through it, around it, so as to answer the only questions they cared about: how to make the client money and, when the walls closed in, how to protect themselves.”

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