When McKinsey Comes to Town

4 ideas

1. McKinsey's plan to turbocharge OxyContin sales

   Even after Purdue Pharma pleaded guilty in 2007 to misbranding OxyContin, McKinsey kept advising it on how to 'turbocharge' sales, including by targeting high-prescribing doctors. In 2017 McKinsey consultants floated the idea that Purdue pay distributors a rebate, estimated at about $14,000, for each customer who overdosed on opioids they had sold. In 2021 McKinsey paid roughly $573 million to settle claims by U.S. states over its opioid work, without admitting wrongdoing.

2. Serving the regulator and the regulated

   McKinsey advised the FDA, the agency overseeing opioids, while it also advised the opioid makers that agency regulated. It also served tobacco and vaping companies alongside public-health bodies. Because the firm treats each client engagement as walled off, it can take fees from opposing sides of the same conflict and access information on both, while no single client can see the whole arrangement.

3. Consultants launder decisions leaders already want

   Executives and officials often hire McKinsey to lend outside authority to cuts or strategies they have already chosen, such as layoffs or reductions in services. The consultant's stamp turns a contested choice into an apparently neutral, data-driven recommendation. This shields the client from blame and gives the firm repeat business.

4. Advice without fingerprints escapes accountability

   McKinsey only advises and never formally decides, and its client work stays confidential, so harms show up in clients' actions rather than on the firm's record. Examples include proposed cuts to food and medical spending for ICE detainees and a strategy report for Saudi Arabia that named dissidents who were later targeted. To judge a consultancy's impact, trace what clients did after an engagement rather than what the firm says it recommended.

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