The consulting giant McKinsey continued its work advising Mass on healthcare and other matters after paying for “illegal and dangerous partnership with Purdue Pharma”
In 2013, a McKinsey & Company consultant joined a pharma representative for a ride around Central Mass. The large consultancy firm had been working for Purdue Pharmaceuticals for about a decade to increase sales of the drug giant’s main product, the opioid OxyContin. Trying to convince doctors to prescribe more of the drug, the two hopped from a CVS, to a rheumatology practice, to a geriatric internal medicine doctor, and the consultant noted her observations.
The sales rep had formerly been able to host lunches at hospitals and walk the floors, but now he was getting letters telling him not to come back after trying to introduce himself to a secretary. The observing consultant wrote this all in an email to the Purdue team at McKinsey, adding that while physicians he couldn’t meet with still prescribed OxyContin, it was “demoralizing that he cannot have an impact on them.” Sales reps sometimes struggled to get doctors to prescribe their addictive product, and with the opioid epidemic in clearer view than ever before up to that point, their hesitance was hurting the pharma giant.
McKinsey’s solution to the overall problem was a “sales transformation journey”—increase sales calls, profile and target the top opioid-prescribing physicians, and find ways to influence those hard to see doctors. Over time, such work and advice helped deepen a crisis that has taken hundreds of thousands of American lives.
Working tirelessly and against the mighty force of the pharmaceutical lobby and complicit politicians, state and federal prosecutors eventually fought back with unprecedented success. McKinsey was among the first to pay up; in 2021, the multinational consulting firm settled with attorneys general from 47 states, the District of Columbia, and five territories to pay more than $573 million, with $13.2 million going to Massachusetts.
McKinsey had helped orchestrate the opioid crisis and made $93 million, in the process shredding relevant documents, a crime that landed senior partner Martin Elling in prison for six months. (The company later apologized and shared court documents showing that it had “knowingly and intentionally conspired with Purdue and others to aid and abet the misbranding of prescription drugs.”)
“Today’s agreement sets a new standard for accountability in one of the most devastating crises of our time,” Mass Attorney General Maura Healey said at the time. The future governor who would soon campaign on the merits of her beatdown of Big Pharma added: “As a result, our communities will receive substantial resources for treatment, prevention, and recovery services, and families who have seen their loved ones hurt and killed by the opioid epidemic will have the truth exposed about McKinsey’s illegal and dangerous partnership with Purdue Pharma.”
It was among the first additions to what has become a growing list of massive payments that will direct upwards of a billion dollars to Mass intended to mitigate the resulting crisis by 2038. But despite that settlement and a $650 million deferred prosecution agreement the company reached with the Department of Justice last year, McKinsey has continued doing big government business—including in states it paid settlements to. In 2021, the firm paid nearly $11 million to Mass, the first of five payments totalling more than $13 million. But it didn’t even net a loss here. That year, the commonwealth paid McKinsey in excess of $600,000 more than was received in abatement funds.
After advising drug manufacturers to “turbocharge” opioid sales, target “high potential physicians” who would overprescribe their narcotic, and corner the addiction treatment market to become an “end to end pain provider,” McKinsey was hired for several lucrative state contracts. In the past 13 years, Massachusetts taxpayers have subsidized more than $100 million to the consulting firm for various services, over $30 million coming since the settlement nearly five years ago.
Keeping the state checkbook open for McKinsey after its opioid settlement
McKinsey currently has four active contracts with Massachusetts, the longest of which end in 2034. These procurements range from IT project management work relating to sensitive data and user-end design for state online services, to consultancy work on education, racial and health equity, downtown revitalization, zoning, and several other fields.
Such services have already been used and paid for by state departments including the Executive Office of Health and Human Services (EOHHS), Executive Office of Labor and Workforce Development (EOLWD), Department of Mental Health (DMH), and Department of Public Health (DPH). Its work for the state predates this, including a 2016 contract with the MBTA that pushed for privatization and a 2020 contract with the Department of Elementary and Secondary Education.
Much of McKinsey’s post-settlement work in Mass relates to public health and COVID, with the majority of the payments to the firm coming from either designated pandemic relief funds or otherwise appropriated for “Epidemiology And Laboratory Capacity For Infectious Diseases.”
In 2021, the Boston Institute for Nonprofit Journalism reported that one of McKinsey’s roles during COVID was to analyze what would happen if Gov. Charlie Baker lifted the eviction moratorium he had ordered earlier that year. McKinsey was charged with providing “support in modeling the impact of various programs under consideration by the state in response to the lifting of moratorium on evictions.” Baker lifted the moratorium four days after the contract amendment was signed.
The state under that administration continued to award McKinsey with work related to the pandemic, eventually to the tune of more than $20 million. That pile included $5.2 million from the Massachusetts Coronavirus Relief Fund, dollars that were by order designated for costs “necessary due to the COVID-19 public health emergency.”
McKinsey’s coronavirus contracts drew high-profile criticism from then-AG Healey, particularly one procurement to study the “future of work” post-pandemic. Having led the case against McKinsey for Mass, she pointed out the damage that the firm had done.
“The Administration should not be enriching a company that has profited from the devastation of our communities,” Healey tweeted. “After what they did to families here, why would we reward them w/ more state contracts? The Administration has paid them $17M since July. It’s outrageous.”
Healey was sworn in as governor in January 2023. The state cut its most recent check to McKinsey that November, 10 months into her administration. The governor’s press office did not respond to a request for comment.
Since the settlement, McKinsey has attempted to clear its name of the suffering it caused. In their apology last year, the firm released a statement saying it was “deeply sorry” and that “our past work for opioid manufacturers will always be a source of profound regret.” A representative for McKinsey declined a request to comment on contracts with Massachusetts.
Contracting with state and federal food and health regulators
The amount of pandemic-related contracts McKinsey was awarded landed the company inside government departments that were simultaneously working to address the very opioid crisis it accelerated. Since the settlement, 83% of the money McKinsey has received from Massachusetts was for work in health departments, including the DPH, an increase from 66% before the settlement. While these services are not directly related to the opioid crisis, these are among the departments that are tasked with expending the funds partially derived from the 2021 settlement.
This is not the first time that McKinsey has worked for government agencies that actively combat harm the firm contributed to. In 2022, New York Congresswoman Carolyn Maloney called out the company for hiding its work for Big Pharma from the Food and Drug Administration. The then-chair of the House Committee on Oversight and Reform said McKinsey “leveraged their federal connections to secure even more private sector business and tried to influence key public health officials on behalf of clients like Purdue Pharma.”
“The community was misled. Clinicians were misled, the general population was misled.” Dr. Tom Stopka, an epidemiologist at Tufts University, spoke directly of Purdue and McKinsey’s opioid sales policies. “They were told that prescription opioids like OxyContin were not addictive. And that was not true.”
Though the 2021 settlement with McKinsey laid out a system to avoid conflicts of interest in future government contracts, that system relies on McKinsey’s judgement. It advises McKinsey that if, “in the view of a neutral and detached observer,” its work for a business client might pose a threat to a government client’s interest, McKinsey is required to review itself. If it finds an issue, it “agrees to decline the work for the Government Client,” according to the settlement.
Lobbying, Project Tango, and consulting on recovery drugs
McKinsey’s strong relationship with the state also shows up in its lobbying and contribution habits. In the past 20 years, individuals working for the company have contributed more than $200,000 in total to Mass politicians, including more than $30,000 alone for Senator Elizabeth Warren’s 2020 presidential bid.
On the lobbying side, McKinsey only seems to have started to seek that kind of influence in Massachusetts last year. In 2024 and 2025, the company paid Smith, Costello, and Crawford Public Policy Group a total of $90,000 for “[m]onitoring legislative and regulatory developments; pursuing business development opportunities.”
Previously, McKinsey underlined its strong political relationships as a key strategy in furthering Purdue’s interests. In consulting between 2014 and 2015 on Project Tango, a Purdue policy aimed at satisfying the need for addiction treatment it helped create, McKinsey emphasized “[r]elationships with local/national regulators” and “[d]eveloping/implementing a policy legislative agenda around medication assisted treatment [MAT].”
McKinsey’s work in this realm aimed to give Purdue a monopoly on pain, cornering the MAT market. In a 2024 case study by researchers at Penn State, analysts evaluated Project Tango, which they found “was one part of a broader strategy by Purdue Pharma to adapt and profit from the existing landscape of structural racism in medical care by investing more in drug sales and targeting medically underserved patients, particularly Black and Latino populations, and those enrolled in Medicaid.”
Highlighting the inhumanity of the gambit, the researchers “contextualize[d] the results to underline the importance of processes of structural racism to segmenting the pain management and substance use treatment markets in a manner that sought to capitalize on the very racism that prevented Asian, Black, Indigenous and Latino patients from obtaining pharmaceutical relief in the earlier days of the epidemic”
Becoming “unsick” and the enduring devastation of opioid addiction
The “turbocharge” policy that McKinsey pushed intended to maximize opioid sales, no matter the destruction to families and communities. Vastly misrepresenting the dangers of opioids, sales reps actively sought out doctors who sold the most of their product, organized into massive databases by McKinsey, and received huge bonuses for their work.
“It started a chain of events, it opened the door for many, many more people to succumb to opioid use disorder,” Stopka, the Tufts epidemiologist said. “Once doctors realized the damage opioids had done, they stopped prescribing them at the rate they had been before. Without access to the drug, millions of addicts started to go through withdrawal.”
Speaking of how so many people turned to dangerous illicit markets—first heroin, and eventually incredibly deadly synthetic opioids such as fentanyl, he added: “They needed to become unsick.”
According to DPH data, more than 30,000 people have died in Mass from opioid use since 2000. In 2022, the same department, tasked with protecting public health in the commonwealth, paid McKinsey more than $7 million for consultant services.
