McKinsey Advised Purdue on "Turbocharging" OxyContin Sales, Targeting High-Volume Prescribers

Documents released in late 2020 in federal bankruptcy court revealed that elite management consulting firm McKinsey & Company worked closely with Purdue Pharma and the Sackler family, developing detailed plans to “turbocharge” OxyContin sales at a time when opioid abuse had already killed hundreds of thousands of Americans. McKinsey’s recommendations focused on intensifying marketing to the highest-volume opioid prescribers in the country, demonstrating how prestigious consulting firms enabled the deadly opioid epidemic.

“Evolve to Excellence” Initiative

McKinsey sent Purdue a memo outlining an initiative labeled “Evolve to Excellence” (E2E), which it suggested would “Turbocharge the Sales Engine.” The E2E program focused on:

• Intensifying marketing to highest-volume prescribers
• Targeting doctors with increased frequency
• Minimizing sales representative discretion in identifying prescribers
• Pushing higher, more lucrative dosages
• Distributing OxyContin directly to patients and pharmacies

The use of the term “turbocharge” demonstrated McKinsey’s awareness that it was accelerating sales of a drug already at the center of a national crisis.

Rebates for Overdoses

In one of the most shocking recommendations, McKinsey advised Purdue in 2013 to offer distributors rebates worth $14,810 for each customer that overdosed on opioids. This proposal explicitly tied financial incentives to overdose deaths, treating dead Americans as business costs to be offset through pricing adjustments.

The recommendation demonstrated McKinsey’s knowledge that increased OxyContin sales would lead directly to increased overdoses and deaths, yet the firm proposed financial mechanisms to maintain profitability despite this foreseeable harm.

Targeting High-Volume Prescribers

McKinsey’s 2013 recommendations included focusing sales calls on high-volume opioid prescribers—doctors already prescribing large quantities of opioids who represented the highest risk for inappropriate prescribing. Rather than encouraging responsible prescribing, McKinsey advised Purdue to double down on the most aggressive prescribers.

This targeting strategy prioritized sales maximization over patient safety, systematically directing marketing resources toward the prescribers most likely to contribute to addiction and overdose.

Document Destruction

As legal risks grew, McKinsey partners discussed eliminating evidence. In July 2018, a McKinsey senior partner wrote in an email about eliminating documents and emails. This destruction of evidence demonstrated consciousness of wrongdoing and attempted to prevent accountability for the firm’s role in the epidemic.

The attempted cover-up paralleled strategies used by tobacco companies decades earlier when facing litigation over smoking-related deaths—destroy evidence to avoid legal liability for known harms.

Timeline: Advising During Crisis Peak

McKinsey’s work for Purdue continued well after the crisis was publicly recognized:

• Purdue pleaded guilty to criminal misbranding in 2007
• McKinsey provided “turbocharging” advice in 2013
• By 2013, over 200,000 Americans had died from opioid overdoses
• McKinsey continued working with Purdue through at least 2018

The firm provided advice to accelerate sales of a drug at the center of a public health catastrophe that had already killed hundreds of thousands, demonstrating prioritization of client profits over public welfare.

Rare Apology

In December 2020, McKinsey issued a rare public apology for its behind-the-scenes work with Purdue Pharma. The apology came only after court documents publicly revealed the firm’s role, suggesting it was motivated by public relations damage control rather than genuine accountability.

Senators and public health advocates called McKinsey’s behavior “abhorrent,” noting that the world’s most prestigious consulting firm had advised a client on how to maximize sales of addictive drugs killing Americans.

$650 Million Settlement, No Prosecutions

In December 2024, McKinsey agreed to pay $650 million to resolve criminal investigations into its role in fueling the opioid crisis. However, no McKinsey executives or consultants faced criminal prosecution despite documented evidence of:

• Advising strategies to “turbocharge” sales of addictive drugs
• Proposing rebates tied to overdose deaths
• Targeting high-risk prescribers for intensified marketing
• Destroying evidence as legal risks grew

The settlement followed the pattern throughout the opioid crisis: large corporate payments, but zero personal accountability for executives and professionals who designed and implemented deadly strategies.

Conflict of Interest: Serving Both Sides

Adding to the scandal, McKinsey simultaneously worked for Purdue Pharma and for federal agencies attempting to regulate the opioid crisis. A House committee investigation revealed McKinsey “helped turbocharge opioid sales while working for US regulators,” creating profound conflicts of interest that undermined regulatory effectiveness.

This dual role exemplified the revolving door and consulting firm capture that enables corporate misconduct—McKinsey could advise Purdue on maximizing sales while also advising regulators on addressing the crisis, ensuring neither client faced effective opposition.

Elite Firm Enabling Death for Profit

McKinsey’s role demonstrates how elite professional services firms enable corporate misconduct. The firm’s consultants:

• Attended prestigious universities
• Earned lucrative salaries
• Worked for the “world’s most elite consulting firm”
• Yet designed strategies to maximize sales of drugs killing Americans

The case illustrates what one commentator called “the banality of evil, MBA edition”—well-educated professionals designing death-dealing strategies in PowerPoint presentations, treating overdoses as business problems requiring financial optimization.

Pattern: Consultants Escape Accountability

McKinsey’s eventual $650 million settlement (equivalent to roughly 10 days of revenue for the $12+ billion annual revenue firm) came without criminal charges for any consultants or partners. This continued the pattern where professional services firms face corporate penalties but individual professionals avoid prosecution, even when they personally designed and recommended strategies that killed thousands.

Broader Pharmaceutical Consulting Role

McKinsey’s work for Purdue was not isolated. The firm consulted for multiple pharmaceutical companies on opioid marketing strategies, helping shape industry-wide approaches to promoting addictive painkillers. Documents revealed McKinsey advised numerous drugmakers on how to maximize opioid sales, making the firm a central architect of the strategies that fueled the epidemic.

Accountability Delayed, Damages Limited

McKinsey’s role was not publicly revealed until 2020—24 years after OxyContin’s launch and 7 years after providing “turbocharging” advice. The multi-year delay meant:

• McKinsey earned substantial fees before facing consequences
• Thousands died while consulting services continued
• Evidence was destroyed before legal discovery
• Settlements came too late to prevent harm

Deterrence Failure for Professional Services

McKinsey’s settlement without criminal prosecution established that even prestigious professional services firms can:

• Advise clients on strategies known to cause deaths
• Propose payment schemes explicitly tied to overdoses
• Destroy evidence of misconduct
• Face only corporate financial penalties
• Continue operating without structural reform

This creates moral hazard for the entire consulting industry: firms can profit from advising deadly strategies, pay settlements from corporate funds if caught, while individual consultants face no personal consequences and continue their careers.

Institutional Corruption at Highest Levels

McKinsey’s role reveals how institutional corruption operates at the highest levels of American business. The firm that advises Fortune 500 CEOs, government leaders, and global institutions used its expertise to maximize deaths for client profit. The case demonstrates that elite credentials and prestigious reputations provide no guarantee of ethical conduct—indeed, such firms may be particularly effective at enabling harmful strategies while maintaining respectability.

This case represents a watershed moment revealing how America’s most respected professional institutions can become mechanisms for corporate harm, designing and implementing strategies that kill hundreds of thousands while maintaining the appearance of legitimate business consulting, ultimately facing only limited financial consequences without criminal accountability for the architects of deadly strategies.