This week the NYT broke the story that McKinsey’s involvement among multiple parties helped create the lack of oversight between the FDA, Secretary of Health and Purdue Pharma. If the opioid crisis was a layer cake, McKinsey’s consulting would be like the icing between each layer.
The global consulting juggernaut McKinsey used the same consultants in key strategy positions at both Purdue Pharma and the FDA. A McKinsey consultant pitched his pharma services as being about “who we know and what we know.”
McKinsey consultants have been found to have conflicting interests with several regulatory parties, and a particularly tight relationship with Trump’s appointed Secretary of Health and Human Services. Mr. Azar was previously a big pharma president of Eli Lilly (US), and he consulted with McKinsey to look for opportunities in the interim between Eli Lilly and Secretary. According to the New York Times:
“McKinsey consultants had begun drafting a detailed memo to Mr. Azar before his confirmation, the documents show, in which they outlined major issues he would face. One paragraph offered a blunt assessment of the continued severity of the opioid crisis. It said that two programs Mr. Azar would oversee as secretary — Medicare and Medicaid — were contributing to the problem by allowing opioids to be dispensed to people prone to abuse them and in doses too high.
But those references were deleted after a consultant working for Purdue, Arnab Ghatak, objected to them. In addition, heeding some of Mr. Ghatak’s suggestions, the final version added language that broadened responsibility for the crisis to include generic manufacturers and illicit heroin use.”
Consultants such as Jeff Smith a co-engagement director worked extensively between the FDA and Purdue Pharma at the same time. Jeff Smith provided Purdue Pharma what to expect coming down the pipeline from the FDA, because he was also a key player in structuring the FDA. The screengrabs below from the NYT piece show Jeff Smith as a Purdue and FDA consultant.
| Once Purdue Pharma came under scrutiny, there is an existing digital trail of McKinsey consultants trying to delete, obscure, and minimize their contributions to Purdue. One of several examples shows a 2017 text message to Purdue’s McKinsey consultant (Ghatak) from a McKinsey partner who was starting to feel uncomfortable emailing materials to Purdue, “these guys will be deposed, best our emails are not sucked into it.” Separately, Politico released an in-depth examination this week, “The FDA’s Food Failure,” which outlines the bureaucratic failures to fend off lobbying from the private food and drug industries. In a section titled “It’s A Structure That’s Designed To Fail,” Politico attributes restructuring implemented by McKinsey as part of why the FDA is so dysfunctional. The unconventional McKinsey structure laid out in 2017 created confusion over who does what and power struggles that challenge the FDA to regulate anything promptly. |
