[House Hearing, 117 Congress]
[From the U.S. Government Publishing Office]


                    MCKINSEY & COMPANY'S CONDUCT AND
                     CONFLICTS AT THE HEART OF THE
                            OPIOID EPIDEMIC

=======================================================================

                                HEARING

                               BEFORE THE

                              COMMITTEE ON
                          OVERSIGHT AND REFORM
                        HOUSE OF REPRESENTATIVES

                    ONE HUNDRED SEVENTEENTH CONGRESS

                             SECOND SESSION

                               __________

                             APRIL 27, 2022

                               __________

                           Serial No. 117-79

                               __________

      Printed for the use of the Committee on Oversight and Reform
      
[GRAPHIC NOT AVAILABLE IN TIFF FORMAT]


                       Available on: govinfo.gov,
                         oversight.house.gov or
                             docs.house.gov
                             
                              __________

                    U.S. GOVERNMENT PUBLISHING OFFICE                    
47-526 PDF                 WASHINGTON : 2022                     
          
-----------------------------------------------------------------------------------                               
                             
                             
                             
                   COMMITTEE ON OVERSIGHT AND REFORM

                CAROLYN B. MALONEY, New York, Chairwoman

Eleanor Holmes Norton, District of   James Comer, Kentucky, Ranking 
    Columbia                             Minority Member
Stephen F. Lynch, Massachusetts      Jim Jordan, Ohio
Jim Cooper, Tennessee                Virginia Foxx, North Carolina
Gerald E. Connolly, Virginia         Jody B. Hice, Georgia
Raja Krishnamoorthi, Illinois        Glenn Grothman, Wisconsin
Jamie Raskin, Maryland               Michael Cloud, Texas
Ro Khanna, California                Bob Gibbs, Ohio
Kweisi Mfume, Maryland               Clay Higgins, Louisiana
Alexandria Ocasio-Cortez, New York   Ralph Norman, South Carolina
Rashida Tlaib, Michigan              Pete Sessions, Texas
Katie Porter, California             Fred Keller, Pennsylvania
Cori Bush, Missouri                  Andy Biggs, Arizona
Shontel M. Brown, Ohio               Andrew Clyde, Georgia
Danny K. Davis, Illinois             Nancy Mace, South Carolina
Debbie Wasserman Schultz, Florida    Scott Franklin, Florida
Peter Welch, Vermont                 Jake LaTurner, Kansas
Henry C. ``Hank'' Johnson, Jr.,      Pat Fallon, Texas
    Georgia                          Yvette Herrell, New Mexico
John P. Sarbanes, Maryland           Byron Donalds, Florida
Jackie Speier, California            Vacancy
Robin L. Kelly, Illinois
Brenda L. Lawrence, Michigan
Mark DeSaulnier, California
Jimmy Gomez, California
Ayanna Pressley, Massachusetts

                      Russ Anello, Staff Director
              Richard Trumka, Subcommittee Staff Director
                    Amy Stratton, Deputy Chief Clerk

                      Contact Number: 202-225-5051

                  Mark Marin, Minority Staff Director
                                 ------                                
                        
                        C  O  N  T  E  N  T  S

                              ----------                              
                                                                   Page
Hearing held on April 27, 2022...................................     1

                               Witnesses

Mr. Bob Sternfels, Global Managing Partner, McKinsey & Company
    Oral Statement...............................................     6

The Honorable Maura Healey, Attorney General, Commonwealth of 
  Massachusetts, in Joint Testimony with Ms. Gillian Feiner, 
  Senior Enforcement Counsel, Massachusetts Attorney General's 
  Office
    Oral Statement...............................................     8

Mr. Uttam Dhillons, Chair, Regulatory Defense, Compliance & White 
  Collar Practice Group, Michael Best & Friedrich LLP
    Oral Statement...............................................    10

Professor Jessica Tillipman, Assistant Dean for Government 
  Procurement Law Studies, George Washington University Law 
  School
    Oral Statement...............................................    11

 Opening statements and the prepared statements for the witnesses 
  are available in the U.S. House of Representatives Repository 
  at: docs.house.gov.

                           INDEX OF DOCUMENTS

                              ----------                              

No additional documents were submitted for this hearing.


 
                    MCKINSEY & COMPANY'S CONDUCT AND
                     CONFLICTS AT THE HEART OF THE
                            OPIOID EPIDEMIC

                              ----------                              


                       Wednesday, April 27, 2022

                  House of Representatives,
                 Committee on Oversight and Reform,
                                                   Washington, D.C.

    The committee met, pursuant to notice, at 10:08 a.m., in 
room 2154, Rayburn House Office Building, and via Zoom; Hon. 
Carolyn B. Maloney [chairwoman of the committee] presiding.
    Present: Representatives Maloney, Norton, Connolly, 
Krishnamoorthi, Khanna, Mfume, Tlaib, Porter, Bush, Davis, 
Welch, Johnson, Kelly, DeSaulnier, Pressley, Comer, Jordan, 
Foxx, Grothman, Cloud, Higgins, Norman, Keller, LaTurner, 
Fallon, Herrell, and Donalds.
    Chairwoman Maloney. The committee will come to order.
    Without objection, the chair is authorized to declare a 
recess of the committee at any time. I now recognize myself for 
an opening statement.
    Good morning and thank all of you for coming. Today, we are 
holding the third hearing that I have convened as chair on our 
Nation's deadly opioid epidemic.
    My goal is simple, to promote accountability and seek 
justice for the millions of families whose lives have been 
ravaged by this epidemic and to protect Americans from 
suffering from more harm.
    Our committee has examined the role of Purdue Pharma, which 
got millions of Americans hooked on the pain killer Oxycontin 
despite knowing it was highly addictive. We have also 
investigated the role of the Sackler family, which made 
billions of dollars fueling a public health crisis that has 
killed half a million people in our country and counting.
    Today's hearing focuses on another key driver of the 
epidemic that operated behind the scenes, the consulting firm 
McKinsey and Company. For nearly 15 years, McKinsey secretly 
designed strategies for companies like Purdue to boost sales of 
addictive painkillers, paving the way for an explosion of drug 
abuse and overdoses across the country.
    Documents show that McKinsey created a roadmap for these 
drug companies to, quote, ``turbo charge'', end quote, opioid 
sales. Some of the advice McKinsey provided is absolutely 
shocking beyond belief.
    In 2017, after the opioid epidemic had been declared a 
public health emergency, McKinsey recommended that Purdue offer 
pharmacy benefit managers a rebate of thousands of dollars for 
each overdose caused by the opioid pills.
    McKinsey's goals, it seems, was to make sure that mounting 
concerns about overdoses did not slow down sales. Apparently, 
this advice was too shocking even for Purdue to accept. Thanks 
to the tireless work of state attorneys general, we have 
finally begun to expose McKinsey's secret role in this health 
crisis.
    I am deeply grateful for the participation today of 
Massachusetts Attorney General Maura Healey, who has been 
leading the fight for accountability from Purdue, the Sacklers, 
and McKinsey.
    Our committee launched our own investigation into McKinsey 
more than five months ago. We have learned that at the same 
time McKinsey was providing secret advice to Purdue to boost 
opioid sales the firm was also consulting for the Food and Drug 
Administration, which oversees the opioid industry. In other 
words, McKinsey was advising both the fox and the henhouse and 
getting paid by both.
    The committee recently released a staff report showing that 
at least 22 McKinsey consultants work for both the FDA and 
opioid companies, often at the very same time.
    Now, McKinsey has defended this conduct claiming that the 
firm did not work for the FDA on specific opioid regulation or 
approvals. But the truth is there was obvious connections 
between McKinsey's work for FDA and for opioid companies.
    For example, in 2009, McKinsey advised opioid companies to 
quote, ``band together'', end quote, to, quote, ``defend 
against strict treatment by the FDA,'' end quote.
    Then, in 2011, McKinsey began working for the very FDA 
offices overseeing the opioid industry. The assignment was set 
to, quote, ``strategic goals and objectives and to improve drug 
safety and address adverse health impacts.'' Clearly, McKinsey 
should not be setting strategy for both drug companies and the 
FDA.
    Since 2008, McKinsey has collected $140 million from the 
FDA. Just yesterday the FDA announced at a Senate hearing that 
it has stopped issuing contracts to McKinsey while 
investigations into its conduct are ongoing. Documents 
uncovered by the committee also paint a damning picture of how 
McKinsey used its Federal connections to advance its private 
sector business interests.
    In a sales pitch to Purdue's CEO, McKinsey bragged about, 
quote, ``who we know and what we know, including the FDA.'' In 
2018, the firm sent a private memo to--they sent a private memo 
to President Trump's Secretary of Health and Human Services, 
Alex Azar. The memo was edited by consultants working for 
Purdue with one consultant urging that the memo should 
emphasize the, quote, ``important societal benefit'' end quote, 
of opioids. McKinsey's conflict of interests was undeniable, 
they were long lasting, and they were detrimental to public 
health.
    Today, our committee will reveal new documents that raise 
even more questions about McKinsey's role in the opioid crisis. 
These documents show that the firm recommended a, quote, ``cash 
prize'', end quote, and other perks to boost opioid sales, and 
urged companies to target communities that were already hard 
hit by opioids.
    McKinsey's conflicts and conduct are among the worst I have 
seen in my years in government. McKinsey has apologized for 
some of its conduct but it continues to deny its conflicts of 
interest, raising doubts about whether it has really learned 
from its mistakes.
    McKinsey also continues to withhold key information from 
this committee, including client lists and staffing information 
that could reveal the extent of the company's role in the 
opioid crisis and problems in other areas.
    Today we will hear from McKinsey's managing partner, Bob 
Sternfels, and I hope we will get some answers about his 
company's practices. Today, I am also introducing legislation 
to ensure that we have stronger guardrails on conflicts in the 
future.
    I want to thank Senator Peters, in partnership with Senator 
Grassley, for their leadership in developing this bipartisan 
legislation. We can no longer tolerate it when companies and 
Federal contractors put their profits over the health and 
safety of the American people.
    I now recognize the distinguished ranking member, Mr. 
Comer, for an opening statement.
    Mr. Comer. Thank you, Madam Chair, and I want to thank our 
witnesses who are here today.
    The opioid epidemic has caused untold harm to millions of 
Americans, and in my district in rural Kentucky, thousands of 
my constituents have lost friends and loved ones to this 
devastating crisis.
    But today's hearing is not about how to end the opioid 
epidemic. If it were, we would have officials from the Biden 
administration here testifying. President Biden has been in 
office for over a year.
    Yet, we have not had any cabinet level officials here to 
testify about the many crises affecting America today. Zero 
Biden cabinet officials before the Oversight Committee.
    Instead, the majority has allowed other committees to 
conduct the oversight this committee should be doing. This week 
alone House committees will hold 14 different hearings with 
cabinet secretaries and four more with agency heads. Today, the 
Energy and Commerce Committee will hold a hearing with the 
Secretary of Health and Human Services, Xavier Becerra.
    This committee should have him here to explain why a 
teacher's union was allowed rewrite the CDC's school reopening 
guidance to effectively keep thousands of schools shuttered.
    A career CDC official told us this level of coordination 
was uncommon, contradicting Dr. Walensky's assertion it was 
customary. And while he is at it, let us talk about the CDC's 
jumbled guidance on all things COVID because CDC continues to 
push for COVID mandates on Americans but seeks to end public 
health expulsions for illegal immigrants crossing the southern 
border--Title 42.
    Tomorrow, Secretary of State Antony Blinken will testify 
before the House Appropriations and the House Foreign Affairs 
Committees. This committee should have him here to testify 
about the war in Ukraine, the botched withdrawal from 
Afghanistan, and the failures of the Afghani refugee program. 
We have a question--Republicans.
    How many Afghanis are over here? We can't get an accounting 
of that. I know this. It is significantly more than we were 
told were going to come to the United states. That is why 
committee Republicans have already requested that Secretary 
Blinken come testify.
    Also tomorrow the Secretary of Energy Jennifer Granholm 
will testify before the Energy and Commerce Committee and the 
House Appropriations Committee. This committee should be where 
the Secretary of Energy comes to testify about rising gas 
prices and this administration's war on domestic energy 
production.
    That is why committee Republicans have already requested 
that she come to testify before the House Oversight Committee. 
Today and tomorrow Secretary of Homeland Security Mayorkas will 
testify before the House Judiciary Committee, House Homeland 
Security Committee, and the House Appropriations Committee.
    I said earlier in today's hearing it is not about the 
opioid crisis. If it were then Secretary Mayorkas should come 
here to testify about the crisis at the southern border, a 
crisis that is directly fueling this drug epidemic.
    Republicans on the House Oversight Committee just returned 
from our second trip to the border and all we heard was about 
all the fentanyl and crystal meth pouring across the southern 
border.
    We need Secretary Mayorkas here in the Oversight Committee 
to answer our questions. That is why Republicans on this 
committee have requested that he come testify. But Democrats 
and Chairwoman Maloney continue to ignore these requests.
    Democrats aren't interested in fact finding. They want the 
public to believe the opioid crisis is still driven by over 
prescribing. It is not.
    It is driven by the thousands of pounds of fentanyl and 
other illicit opioids pouring across our southern border every 
single day because of President Biden's open border policy.
    Decreasing funding at the border, halting border wall 
construction, and allowing illegal immigrants to make a mockery 
of our immigration laws have made it easy for cartels to 
smuggle the drugs that are killing people in neighborhoods all 
over the country.
    Last year alone over 100,000 Americans died of opioid 
overdoses, most of which were caused by illicit opioids that 
came across our southern border. Yet, this administration does 
everything in its ability to encourage an open border.
    Madam Chair, this is the Oversight Committee. But this 
committee under Democrat leadership isn't conducting oversight. 
In fact, a nonpartisan group gave the Oversight Committee a 
failing grade on oversight.
    Cabinet secretaries are finally coming to the Hill. But 
they are not coming to the Oversight Committee. Democrats' 
refusal to take seriously the core responsibility of this 
committee is damaging our institutional credibility.
    Who needs an oversight committee that does no oversight? 
Come next January things are going to change if Americans 
entrust Republicans with a majority. We will hold the Biden 
administration accountable on behalf of the American people.
    We will seek to root out waste, fraud, abuse, and 
mismanagement in the Federal Government and Americans will get 
answers to the issues that matter most to them--why their 
grocery bills are so high, why it costs so much to fill up 
their gas tank, why prices for everything are so high, why this 
administration was focused on keeping children out of school 
instead of searching for ways to get them back in the 
classroom, why their communities are overrun with illegal 
aliens, why our children are struggling and teens turning to 
illicit drugs laced with fentanyl coming from our open border.
    Next Congress when Republicans take back the House we will 
conduct robust oversight of this administration and find 
answers to these and many, many more questions.
    Republicans are ready to deliver credible oversight that 
produces real results. Americans deserve no less from their 
Congress and no less from the House Oversight Committee.
    Madam Chair, thank you, and I yield back.
    Chairwoman Maloney. The gentleman yields back.
    Let me briefly say that this should not be a partisan issue 
because opioid abuse affects all Americans. All of us have 
people in our district that have died from overdoses, and the 
recent spike in overdose deaths began under the previous 
administration.
    The Biden administration has surged efforts to address this 
crisis. The Department of Homeland Security seized more than 
14,000 pounds of fentanyl last year and just yesterday released 
a new plan to further enhance border security.
    The Homeland Security has Secretary Mayorkas testifying 
today. If you want to go to that hearing and discuss that, then 
go right ahead and do that. But today we are looking at, 
really, the second cause of death in America. It is preceded 
only by COVID.
    For a long time we had more deaths from overdoses, and you 
will see that there were practices where they were giving 
rebates. Pay them more. Pay them more if you kill more people.
    I always try to find a bill to answer problems. What do you 
do, put a bill in don't kill people? It is outrageous what they 
have done. It is serious. It needs to be looked at. The 
conflict of interest has to be looked at and it has to stop.
    Now, I ask unanimous consent to put a listing of the 26 
hearings that we have had in this committee, many of them with 
people that are in the administration, and on many issues that 
are important.
    Chairwoman Maloney. But nothing is more than hope important 
than the health of the American people and opioids is causing 
too many deaths. It is addictive. They said it wasn't addictive 
when it was addictive. It is a serious health problem. It needs 
to be addressed, and I hope we will focus on the issue before 
us.
    Now we need to move on and I would like to introduce our 
witnesses. Our first witness today is Bob Sternfels, who is the 
global managing partner with McKinsey and Company, and I now 
will recognize Ms. Pressley to introduce our next witness, AG 
Healey. She will recognize AG Healey and we thank her so much 
for coming.
    Ms. Pressley?
    Ms. Pressley. Good morning. Thank you, Madam Chair. It is 
really my distinct privilege to introduce Maura Healey, the 
attorney general for the Commonwealth of Massachusetts.
    As the people's lawyer, General Healey has been a national 
leader in efforts to confront the opioid public health crisis, 
which has decimated communities and families in the 
Massachusetts Seventh and throughout the country.
    She has been a champion for families and communities 
targeted, victimized, and traumatized by the corrupt and 
malicious actors that have profited from the opioid epidemic.
    Most notably, Attorney General Healey created a first of 
its kind, a restorative justice-focused opioid recovery and 
remediation fund that takes the ill-gained profits from 
companies like McKinsey and uses them to expand access to 
opioid use disorder prevention, intervention, treatment, and 
recovery options.
    Attorney General Healey, I applaud your leadership. I thank 
you for your many years of friendship and steadfast 
partnership, and I welcome you back to the House Committee on 
Oversight and Reform.
    Ms. Healey. Many thanks to you, Congresswoman Pressley, for 
your work on behalf of so many families devastated by this 
opioid epidemic and crisis.
    To Chairwoman Maloney, Representative Comer, members of the 
committee, thank you for holding this important hearing.
    Chairwoman Maloney. AG Healey, we are introducing all of 
the people and then we are coming back to you, very briefly.
    But, unfortunately, AG Healey has a hard stop at 11 
o'clock, but when she leaves she will be replaced on the panel 
by Gillian Feiner, who is a senior enforcement counsel in the 
Massachusetts AG office.
    Next we will hear from Uttam Dhillon, who is the chair of 
the Regulatory Defense Compliance and White Collar Practice 
Group at Michael Best & Friedrich. Finally, we will hear from 
Jessica Tillipman, who is the assistant dean for government 
procurement law studies at George Washington University Law 
School.
    The witnesses will be unmuted so we can swear them in. 
Please raise your right hand.
    Do you swear or affirm that the testimony you are you are 
about to give is the truth, the whole truth, and nothing but 
the truth, so help you God?
    [Witnesses are sworn.]
    Chairwoman Maloney. Let the record show that the witnesses 
answered in the affirmative. Thank you. And without objection, 
your written statements will be made part of the record.
    With that, Mr. Sternfels, you are now recognized for your 
testimony, and you will be followed by Attorney General Healey.
    Thank you.

 STATEMENT OF BOB STERNFELS, GLOBAL MANAGING PARTNER, MCKINSEY 
                          AND COMPANY

    Mr. Sternfels. Chairwoman Maloney, Ranking Member Comer, 
and members of the committee, thank you for the opportunity to 
be here today to discuss our history, policies, and approach to 
client service.
    McKinsey is one of the world's leading providers of 
business and organizational consulting services serving the 
largest and most significant American and multinational 
companies, institutions, foundations, and not for profit 
entities.
    We were founded in Chicago in 1926, and today we encompass 
more than 38,000 employees globally with more than 12,000 
employees in the United States. We are currently serving more 
than 3,000 clients and nearly half our revenues come from 
clients headquartered in the United States.
    Our work is deeply rooted in American values, including the 
principles of economic growth and mobility, business 
innovation, sustainability, community development, and the rule 
of law.
    Our approach to client service is centered on evidence-
based empirical research, fact-based problem solving, rigorous 
data gathering, and deep economic analysis. Our consulting 
services often require us to work with the clients' most 
sensitive, confidential, and competitively important 
information.
    The protection of this information entrusted to us is, 
therefore, a fundamental value at McKinsey and the backbone of 
our policies on conflict of interest. This is why we have a 
comprehensive set of policies and procedures designed to 
maintain client confidences, protect client data, and avoid
    [technical issue].
    We have also adopted practical guardrails that are 
important to us and our clients, including long-standing 
restrictions on staffing projects where confidential 
information from one client could be used against another 
client.
    These policies and procedures are core to who we are as a 
firm, and when we serve the U.S. Government we take additional 
measures to ensure compliance and accountability. We have a 
separate legal entity with dedicated physical space and 
technology, and additional policies also apply, including our 
organizational conflicts of interest policy, which follows the 
requirements the of Federal Acquisition Regulation.
    We also recognize that we must continue to evolve and 
strengthen our approach to governance and client service. As 
part of our own continuous improvement, in 2019, we launched a 
more rigorous framework and set of criteria to determine which 
clients we serve and on which topics.
    It is by far the most comprehensive and complete client 
service framework in our industry today. We have substantially 
increased our internal resources in the area of risk, legal, 
and compliance. In the last four years alone, our investment 
and professional staff compliance training, technology, and 
related activities have topped $600 million.
    I would now like to turn to the committee's recent staff 
report about McKinsey's work for Purdue Pharma and the FDA. 
Most importantly, McKinsey did not--did not serve both the FDA 
and Purdue on opioid-related matters.
    As both McKinsey and the FDA have made clear, our work for 
the FDA focused on administrative and operational topics, 
including improvements to organization structure, business 
processes, and technology.
    In response to congressional questions, the FDA have been 
equally clear. McKinsey did not consult about any specific drug 
product or product class, and none of our contracts with the 
FDA are related to opioids.
    The staff report has additional flaws. It looked at a time 
period of the work without examining the nature of the work. It 
implied incorrect conflict standards and it took large 
speculative leaps to reach unwarranted findings.
    As one example, the staff report incorrectly said McKinsey 
shared confidential FDA information with its private sector 
clients. In fact, the referenced content was publicly published 
by the FDA more than eight months earlier.
    Madam Chairman, we fully recognize--fully recognize the 
terrible consequences of the opioid epidemic. We have 
acknowledged our role in serving opioid manufacturers and we 
apologize for that work.
    We have been committed to being part of the solution, 
including funding and a settlement that provides more than $575 
million to prevention, treatment, and recovery efforts. We are 
committed to continuing to provide service that are consistent 
with our values and guided by our strong policies on client 
service and conflict of interest.
    Thank you, and I would be happy to answer questions today.
    Chairwoman Maloney. Thank you.
    Attorney General Healey, you are now recognized for your 
testimony.

  STATEMENT OF MAURA HEALEY, ATTORNEY GENERAL OF MASSACHUSETTS

    Ms. Healey. Thank you, Chairwoman Maloney.
    Chairwoman, Representative Comer, members of the committee, 
thank you for convening this important hearing. I am grateful 
to be here today on behalf of the people of Massachusetts, and 
I am here to explain to you why my team investigated McKinsey 
for its role in the opioid crisis, what we uncovered, and what 
we did about it.
    I am here today because of the families who have been so 
hurt by this opioid crisis, thousands of people in our state, 
hundreds of thousands across this country, who today need 
access to treatment and recovery and harm reduction, parents 
who have lost their children, grandparents who are raising 
their grandchildren.
    When I became attorney general, I promised that I would 
uncover what caused this crisis. I would hold the perpetrators 
accountable and make sure that nothing like this ever happens 
again.
    In March 2015, I opened my investigation into Purdue and 
the Sackler family, and that investigation led to further 
investigations, including our investigation of McKinsey and its 
role in fueling this opioid crisis.
    As attorney general, I follow the facts. I follow the law. 
We are prosecutors. We are investigators. We subpoenaed 
documents, we uncovered information, and here is what we 
learned about McKinsey. Through millions of confidential 
documents from Purdue Pharma, from the Sacklers, and from 
McKinsey, this is what we learned. We learned how McKinsey 
worked directly with Purdue and the Sacklers to turbo charge 
Oxycontin sales exactly at the time when people in 
Massachusetts were overdosing and dying.
    We learned that McKinsey consultants worked directly with 
the Sackler billionaires who controlled Purdue. We found that 
McKinsey told the Sacklers to target the most dangerous 
prescribers who put the patients on opioids at the most highest 
levels and at the highest doses for the longest periods of 
time.
    We found that McKinsey coached Purdue to band together with 
other opioid companies to defend against strict treatment by 
the FDA. We found that at the same time that McKinsey was 
working for Purdue the same McKinsey consultants were, in fact, 
also working for the FDA.
    McKinsey went so far as to brag about this. They wrote to 
Purdue's CEO that Purdue should hire McKinsey because of, 
quote, ``who we know,'' close quote, including, specifically, 
because McKinsey worked for the FDA.
    We found that McKinsey did not want the world to know what 
it was doing. When I sued the Sacklers, McKinsey consultants 
read about my investigation and lawsuit and actually planned to 
delete their documents and emails. They wrote that they were 
going to destroy the evidence because, quote, ``someone might 
turn to us,'' close quote.
    I wasn't about to let them get away with that. I worked 
with attorneys generals from both parties to secure a national 
resolution that made McKinsey pay for its misconduct, forced 
McKinsey to change its practices, and required McKinsey to turn 
over its documents to the public for all to see.
    I want to thank Colorado Attorney General Phil Weiser and 
many other colleagues for working with me to hold McKinsey 
accountable. I submitted for the record the court order that 
requires McKinsey to pay and change its ways.
    First, we required McKinsey to pay more than $500 million 
to address the opioid crisis nationwide. In Massachusetts, 
every dollar that we recovered is going to treatment, 
prevention, and harm reduction through a trust fund that is 
overseen by public health experts, by families who have 
experienced substance use disorder, and by representatives from 
Massachusetts' cities and towns.
    Second, we banned McKinsey from the opioid business 
forever.
    Third, if McKinsey ever tries to do business with any 
state, county, or city anywhere in America, we require that 
McKinsey must disclose its conflicts of interest in writing.
    Fourth, to make sure that McKinsey never tries to destroy 
evidence again, we required McKinsey to preserve for five years 
every email and instant message by any of its employees working 
on any matter anywhere in the world.
    And fifth, we required that the documents we uncovered from 
McKinsey's own files will be published on the internet so that 
families who are hurt and everyone else can see the evidence 
for themselves.
    I applaud Chairwoman Maloney and this committee and your 
staff for taking on this important matter. The report that you 
released this month and the hearing that you are holding today 
will help expose dangerous misconduct.
    On behalf of the people of Massachusetts, I thank you.
    Chairwoman Maloney. Thank you for your leadership and thank 
you for your testimony.
    Mr. Dhillon, you are now recognized for your testimony.

    STATEMENT OF UTTAM DHILLON, CHAIR, REGULATORY DEFENSE, 
  COMPLIANCE AND WHITE COLLAR PRACTICE GROUP, MICHAEL BEST & 
                         FRIEDRICH, LLP

    Mr. Dhillon. Chairwoman Maloney, Ranking Member Comer, and 
distinguished members of the Committee on Oversight and Reform, 
thank you for inviting me to testify today.
    In 1997, I joined the House Government Reform and Oversight 
Committee as a senior investigative counsel, the first of 
several positions I have been fortunate to hold on the Hill. 
So, I am very pleased to return to this hearing room to serve 
as a witness at today's hearing.
    I began learning about drug enforcement in the 1990's when 
I served as an assistant United States Attorney in the Central 
District of California, prosecuting drug traffickers and gang 
members, often one and the same.
    During the second Bush Administration, I was nominated by 
the President and unanimously confirmed by the Senate as the 
first director of the Office of Counter Narcotics Enforcement 
at the Department of Homeland Security, a drug policy office 
responsible for working with DHS' counter narcotics agencies.
    And more recently, I had the honor and the privilege to 
lead the brave professionals of the Drug Enforcement 
Administration and to serve as the director of Interpol 
Washington.
    Today, the United States is experiencing the third wave of 
the opioid crisis. The first wave began with a flood of 
prescription opioids.
    Increased pricing and better regulation led to a cheaper, 
more powerful alternative to prescription opioids--heroin--
starting the second wave. The source of the second wave was 
predominantly Mexican drug cartels who poured cheap heroin into 
the U.S., resulting in increased heroin seizures along the 
Southwest border and a dramatic rise in overdose deaths.
    Today, we are in the third wave of the opioid crisis, 
distinguished by the introduction of synthetic opioids such as 
fentanyl into the illicit U.S. drug market. This third wave is 
driven, largely, by the Mexican drug cartels and China's 
willingness to sell fentanyl and fentanyl precursors to those 
cartels.
    Synthetic opioids such as fentanyl are easy to produce, 
easy to conceal, and more lucrative than other drugs. Unlike 
illicit drugs such as cocaine and heroin, drug traffickers do 
not need to control large areas of land to grow coca or opium, 
the plants from which cocaine and heroin are derived, nor are 
they subject to natural forces like droughts or blight.
    The barriers for entry into this synthetic drug market are 
relatively low. All you need is a base understanding of 
chemistry--a basic understanding of chemistry, access to the 
right chemicals, and a distribution network.
    Mexican drug cartels possess these three operating 
requirements and their pivot into synthetic opioids was as 
deadly as it was swift.
    Last year, largely, as a result of illicit drugs smuggled 
into the U.S. across our Southwest border, over 100,000 
Americans died from a drug overdose with more than 70 percent 
dying from synthetic opioids such as fentanyl.
    That is an increase of 30 percent from the previous year. 
Add to that the countless number of Americans suffering from 
substance addiction and this crisis touches virtually every 
American.
    DEA's most recent National Drug Threat Assessment issued in 
March of last year describes the Mexican drug cartels, also 
known as transnational criminal organizations due to the global 
nature of their criminal activity, as, quote, ``the greatest 
drug trafficking threat to the United States,'' close quote.
    These organizations, most notably the Sinaloa Cartel, and 
the Cartel de Jalisco Nueva Generacion, more commonly known as 
CJNG, are large, well-funded, and exceedingly violent.
    They operate with relative impunity in Mexico and are 
responsible for tens of thousands of murders and disappearances 
in that country, and the cartels are taking advantage of our 
unsecured Southwest border by flooding our communities with 
fentanyl, methamphetamine, cocaine, and heroin, and they show 
no signs of abating.
    To make matters even worse, since late 2020, the 
relationship between U.S. and Mexican law enforcement has 
deteriorated significantly. Last year, Mexico's government 
enacted strict regulations curtailing foreign law enforcement 
in Mexico by essentially requiring DEA to tell Mexican 
authorities about its operations and activities in Mexico.
    Given the massive corruption in Mexico, this was the 
equivalent of requiring DEA to communicate its intelligence and 
law enforcement strategies directly to the drug traffickers.
    And just last week, it was reported that one year ago 
Mexico disbanded a select anti-narcotics unit known as the 
Sensitive Investigative Unit that DEA had been working with for 
more than two decades.
    These actions by the Mexican government are devastating 
blows to DEA's ability to fight transnational organized crime 
in Mexico. Mexican President Andres Manuel Lopez Obrador's 
anti-law enforcement tactics are making it very difficult for 
U.S. law enforcement to effectively fight and defeat the drug 
traffickers, largely, responsible for the illicit drugs driving 
America's overdose crisis.
    The unfortunate result of all of this is that without 
immediate action to secure the Southwest border and reestablish 
an effective working relationship between U.S. and Mexican law 
enforcement, Mexican drug trafficking organizations will 
continue to grow stronger in the foreseeable future and we can 
expect to see increasing amounts of illicit drugs entering our 
country, poisoning our communities, and killing even more of 
our fellow citizens.
    Thank you for the opportunity to testify today and I look 
forward to answering the committee's questions.
    Chairwoman Maloney. Thank you.
    Professor Tillipman, you are now recognized for your 
testimony.
    Thank you.

 STATEMENT OF JESSICA TILLIPMAN, ASSISTANT DEAN FOR GOVERNMENT 
   PROCUREMENT LAW STUDIES, GEORGE WASHINGTON UNIVERSITY LAW 
                             SCHOOL

    Ms. Tillipman. Chairwoman Maloney, Ranking Member Comer, 
and the members of the committee, thank you for inviting me to 
testify in this legislative hearing. I am Jessica Tillipman, 
the assistant dean for government procurement law studies at 
the George Washington University Law School.
    In addition to leading the law school's government 
procurement law program, I teach our anti-corruption and 
compliance course. The interim majority staff report provides 
the compelling case study in how conflicts and compliance 
issues significantly undermine the public's confidence in our 
procurement system and the contractors that provide the U.S. 
Government with critical goods and services.
    The U.S. Government procurement system aspires to obtain 
the best goods and services from the best firms at the best 
prices. To attain these goals and ensure taxpayer dollars are 
appropriately safeguarded, the Federal acquisition, or FAR, 
makes clear that the government procurement process demands the 
highest commitment to ethical and unbiased conduct.
    To maintain integrity in the system, entities that do 
business with the government are subject to a patchwork of 
requirements, restrictions, and compliance obligations.
    The House report presents two important questions. First, 
whether the FAR's current organizational conflict of interest, 
or OCI framework, adequately addresses potential conflicts 
between a contractor's public sector and private sector work, 
and if not, what legislative changes could help avoid potential 
conflicts of this nature in the future?
    With respect to the first question, any objective observer 
with a basic understanding of the FAR and access to Google 
would conclude that existing OCI regulations most certainly 
cover conflicts between a contractor's public and private 
sector work.
    As to the second question, the OCI language in the FAR, 
which has remained largely unchanged since 1984, should be 
revisited. It is no longer reflective of modern procurement 
practices and the sophisticated body of OCI case law that has 
developed over the past several decades.
    OCIs are generally separated into three categories, but 
most relevant today is what is referred to as an impaired 
objectivity OCI, which may arise where a contractor's outside 
business relationships create an economic incentive to provide 
biased advice under a government contract.
    Experience suggests that OCIs are more likely to occur in 
contracts involving certain services, such as management 
support services and consultant or other professional services. 
The FAR requires a contracting officer to avoid, neutralize, or 
mitigate significant potential conflicts before contract award.
    To fulfill this obligation, contracting officers depend on 
contractors to disclose actual or even apparent OCIs. The 
failure to disclose information required by an applicable OCI 
clause can lead to a multitude of adverse consequences, 
including contract termination, prosecution for false 
statements, False Claims Act liability, or even suspension and 
debarment.
    Given the potentially severe consequences for failure to 
disclose an actual or potential OCI, most experienced 
contractors take affirmative steps to identify potential 
conflicts of interest and, to the best of their ability, 
mitigate them by, for example, developing firewalls, executing 
nondisclosure agreements, or shifting work to a neutral 
unaffiliated third party.
    All of the issues highlighted in the House report must be 
considered against the backdrop of a growing global consensus 
on the importance of internal ethics and compliance programs 
designed to prevent, detect, and mitigate ethics and corruption 
risks.
    Given the heightened corruption risks and compliance 
obligations associated with government contracts, most 
sophisticated government contractors have invested heavily in 
risk-tailored ethics and compliance programs to reduce the 
risks they face.
    Moreover, given the increased OCI risks associated with 
contracts involving management support and consulting services, 
contractors providing services of this nature would be expected 
to dedicate a greater proportion of their compliance resources 
to this particular aspect of their compliance program.
    Notably, merely adopting an OCI policy is not enough. An 
official policy that appears strong and protective is virtually 
meaningless if ignored. To be clear, an occasional violation or 
deviation does not mean that compliance program is ineffective.
    However, evidence of a systemic disregard for compliance 
policies and procedures, particularly when committed by senior 
leaders, is often very strong evidence of a weak culture of 
compliance.
    In 2011, the FAR Council thoughtfully proposed a revision 
of the FAR's OCI rules that addressed numerous outstanding 
issues.
    Although the rule was ultimately withdrawn, the House 
report reminds us that it is time to revisit the work the FAR 
Council began over a decade ago and bring greater awareness and 
compliance attention to this important issue.
    Thank you for the opportunity to discuss this important 
matter with you. I would be pleased to answer any questions.
    Chairwoman Maloney. Thank you for your testimony.
    I now recognize myself for five minutes.
    Attorney General Healey, your investigation revealed that 
McKinsey helped drug companies increase opioid sales and fight 
against meaningful regulation of opioids. Based on your 
investigation, did McKinsey advise Purdue to undermine Federal 
drug safety measures, and if so, how?
    Ms. Healey. Thank you, Congresswoman. The answer to that 
is, quite simply, absolutely and it is infuriating, and it 
spanned many years.
    If you go back to 2008, there was a time when the FDA was 
actually trying to create a safety program for Oxycontin and 
impose stricter standards, and at that time, McKinsey was 
actively coaching Purdue on how to band together with other 
opioid companies to fight against those stricter safety 
requirements.
    The FDA never implemented the stricter requirements and, of 
course, the opioid epidemic just kept getting worse. I 
submitted today McKinsey's own email from their very own files 
as the first exhibit with my testimony, from their own mouse 
marketing to Purdue and the Sacklers that their relationship, 
basically, with the FDA was something that would benefit Purdue 
and its bottom line.
    Now, you move forward to 2013, another example. This is at 
a time when Americans were overdosing and dying of opioids. 
McKinsey is telling the Sacklers to, quote, ``turbo charge'' 
Oxycontin sales by relentlessly targeting doctors who wrote the 
most dangerous prescriptions for the most patients at the 
highest doses possible, a calculated effort to specifically 
target those prescribers. This is from McKinsey as a way to 
boost more Oxy sales by Purdue.
    McKinsey consultants went so far as to actually get in the 
car with Purdue sales representatives to go pitch opioids to 
doctors, and McKinsey went to Purdue's national sales meeting 
to push their scheme to sell more drugs.
    We found that McKinsey time and time again worked directly 
with Purdue to oppose efforts directed at safety and knowing 
what was happening in terms of people becoming sick, 
overdosing, and dying. McKinsey designed schemes to get more 
people on opioids and, as a result, more people suffered and 
died.
    And I want to raise something as well that I find really 
appalling. One thing that we uncovered is that as thousands of 
people in America were dying, McKinsey was briefing Purdue on 
ways to salvage the opioid business with health insurance 
companies because there was more pressure being brought to bear 
as more recognition that these prescription opioids which in 
Massachusetts alone have accounted for two-thirds of all 
overdoses in our state since 2009--that while this is happening 
and more focus and attention is being brought to bear, McKinsey 
is advising Purdue on how to deal with this and, in particular, 
concerns raised by insurance companies.
    So, here is what McKinsey proposes. They actually propose 
paying a rebate to the insurers for each patient who overdoses. 
Their analyses show that paying a rebate could be a, quote, 
``attractive option'' for Purdue if the payment was in the 
range of $6,000 to $14,000 for each patient who was harmed. The 
money wouldn't go to the patient but it would go to the 
insurance company to encourage them to keep paying for Purdue's 
drugs.
    While we don't believe that this rebate proposal ever got 
traction, it is evidence that McKinsey shouldn't be in this 
business and it is emblematic of the kind of activity that 
McKinsey engaged in with Purdue.
    And to answer your question, it absolutely undermined 
public safety.
    Chairwoman Maloney. Thank you.
    Mr. Sternfels, our committee found that McKinsey made more 
than $140 million consulting for the FDA in 2008 but McKinsey 
has never publicly disclosed how much it made working for 
private opioid companies.
    How much money was your firm paid by Purdue and other 
opioid manufacturers?
    Mr. Sternfels. Congresswoman, I don't have that number 
today. If that is of interest, I am happy to dig that up and 
come back to this committee.
    Chairwoman Maloney. Fine.
    Attorney General Healey, how much money was McKinsey paid 
by Purdue? Do you know?
    Ms. Healey. Forgive me. I was unmuting. Eighty-six million 
dollars.
    Chairwoman Maloney. Eighty-six million dollars. That is a 
lot of money and that is just one of four companies that they 
were paid privately, and we know what kind of advice that 
brought with that money, advice on how to fight Federal 
regulation, increase its own bottom line, knowing that it would 
lead to more opioid overdoses.
    I have many questions but my time is almost expired and I 
want to stick very strictly with the five-minutes because AG 
Healey has an 11 o'clock leave and I want more people to get to 
her.
    But, Mr. Sternfels, can you please make a commitment that 
you will give to this committee the documents that we have 
requested by Friday?
    Mr. Sternfels. Chairwoman, as we have made very clear, our 
intent is to work fully with this committee to answer all the 
scope of questions that you have answered and we will continue 
to do that. So, I think, as we had indicated going into this, 
we are not done on answering your questions and you have my 
commitment that we will continue to provide the information.
    Chairwoman Maloney. Thank you. Thank you. Very briefly, 
will you commit to turning over the complete client list and 
staffing information the committee required requested in 
November in our November letter by this Friday?
    Mr. Sternfels. We will continue to keep working with you, 
Congresswoman, on the questions that you need. Our team is not 
disbanding on helping answer your questions.
    Chairwoman Maloney. Well, the families destroyed by the 
opioid epidemic deserve accountability from your company and we 
will not stop until we get it.
    My time has expired. I now recognize the gentlelady from 
North Carolina.
    Ms. Foxx, you are now recognized for five minutes.
    Ms. Foxx. Thank you, Madam Chair, and if I go over a little 
bit I will note the clock went off but you kept talking.
    Limiting the supply of opioids available on our streets is 
crucial to preventing opioid abuse and overdoses. That is why I 
introduced the Return Act, which aims to pave the way for drug 
take-back programs to provide incentives for individuals to 
turn in their unused opioids for destruction.
    Simply put, we need to keep these drugs off our streets and 
prevent illegal opioids such as fentanyl ever crossing our 
border.
    Mr. Dhillon, would you agree that stopping the illicit 
trafficking of fentanyl across our southern border is, 
arguably, the most important thing we can do to limit opioid 
overdose deaths?
    Mr. Dhillon. Absolutely.
    Ms. Foxx. Thank you. Mr. Dhillon, would the 
administration's actions such as moving to rescind Title 42 and 
moving to stop construction of the border wall help stop the 
flow of fentanyl into the country?
    Mr. Dhillon. Anything that prevents drug traffickers from 
entering into the United States is a good thing. Anything that 
allows a free flow of individuals without screening across our 
Southwest border allows drug traffickers, human traffickers, 
terrorists, and others to freely enter the United States. So, 
anything that prevents that is a bad thing.
    Ms. Foxx. So, do you think that finishing construction of 
the border wall will help CBP gain operational control over the 
border and slow down drug traffickers?
    Mr. Dhillon. Absolutely. Any barrier helps Customs and 
Border Protection. As I am sure you know, if you visited the 
border, Border Patrol will tell you that a wall, a barrier of 
any kind that delays the entry--the illegal entry into the 
United States gives them the opportunity to evict those 
individuals.
    Ms. Foxx. Yes. It is just common sense.
    Mr. Dhillon. It is just common sense. I also would like to 
say----
    Ms. Foxx. Could I ask you another question?
    Mr. Dhillon. Yes, ma'am. But if I could just on CBP, a 
point that I would like to make, in Fiscal Year 2021, the 
highest year on record for assaults against CBP officers in 
history, I think that demonstrates what is happening at our 
Southwest border today.
    Ms. Foxx. Thank you. During your tenure at the Drug 
Enforcement Administration you oversaw the first annual 
decrease in overdose deaths in 30 years. The Trump DHS set an 
all-time high for the amount of drugs seized at the border and 
the Trump administration awarded a record amount in Federal 
grants in support of drug interdiction and public health 
programs.
    What should we do to build off those successes?
    Mr. Dhillon. We need increased border security. We need to 
reestablish our law enforcement relationship with Mexico. It is 
critical for the Drug Enforcement Administration to be able to 
fight drug traffickers at home where they live in Mexico.
    Right now, drug traffickers, as a result of the policies of 
the Mexican administration, have free rein in Mexico. They have 
free rein at the border. There are literally hundreds if not 
thousands of drug traffickers associated or members of drug 
cartels--the Sinaloa Cartel, the CJNG Cartel--right here in the 
United States. We need to attack them at all those levels.
    Ms. Foxx. Right. Republicans have sent five letters to the 
chairwoman asking her to hold a hearing on Biden's border 
crisis and the need to secure the southern border. So far, we 
have not heard any hearing--had any hearings on this issue.
    If we do not address the crisis at the southern border will 
we be able to stem the tide of opioid abuse in this country?
    Mr. Dhillon. Absolutely not. I believe that if we do not 
secure the Southwest border, the drug cartels will continue to 
flood this country with even more fentanyl, methamphetamine, 
cocaine.
    It is important to recognize also that Americans are dying 
at record numbers from methamphetamine and cocaine overdoses. 
We are focusing on fentanyl because we see more Americans dying 
as a result of opioids.
    But there are other drugs that are killing Americans, too. 
We have record overdose deaths here and the only way to stop it 
is to stop the drugs from coming into the U.S. and the majority 
are coming through the Southwest border.
    Ms. Foxx. Well, you already touched on my last questions in 
that comment, but just, say, all together, that there is a lot 
at stake on the southern border if we do not stop this drug 
trafficking, and you have mentioned the transnational criminal 
organizations coming into our country.
    Are they going to continue to grow and import their 
violence into the U.S.?
    Mr. Dhillon. Absolutely. There is no reason for them not 
to. This is a multi-billion dollar trade and when you have 
billions of dollars involved and criminal organization--global 
criminal organizations fighting for every dollar, you can 
expect violence to increase as a result.
    Ms. Foxx. Thank you. Thank you, Madam Chairman. I didn't 
need my time.
    Chairwoman Maloney. The gentlelady yields back.
    As announced at the beginning of this hearing, Attorney 
General Healey has a hard stop at 11 o'clock. Attorney General 
Healey, we thank you for your testimony. You are excused. We 
will pause for a moment while Ms. Feiner gets on the camera. 
Thank you so much for your leadership.
    Ms. Healey. Thank you.
    [Pause.]
    Chairwoman Maloney. Thank you. The gentlelady from the 
District of Columbia, Ms. Norton, is recognized for five 
minutes.
    Ms. Norton?
    Ms. Norton. Thank you, Madam Chair, for this important 
hearing. It is only in recent years that McKinsey's role in 
helping Purdue to flood the--our communities with highly 
addictive painkillers has come to light. Two weeks ago, the 
committee released an interim staff report that found that 
McKinsey didn't just work for both FDA and Purdue, they staffed 
some of the exact same people for those contracts.
    Dean Tillipman, when a government contractor uses the exact 
same personnel for both private sector and public sector work, 
are there any potential red flags for conflict of interest?
    Ms. Tillipman. Thank you for your question, Congresswoman.
    An OCI analysis is very fact-intensive analysis. 
Nevertheless, depending on the nature of that work, if there is 
a potential of significant overlap it could raise significant 
red flags about the presence of an OCI.
    Ms. Norton. Mr. Sternfels, you are the global managing 
partner of McKinsey. You have also held roles with 
responsibility for McKinsey operations. The buck, therefore, 
clearly, stops with you.
    When did you first become aware that McKinsey staffed the 
same consultants at Federal regulators and private sector 
companies with matters before them?
    Mr. Sternfels. Thank you, Congresswoman, and I would also 
just start by we fully recognize the travesty that this crisis 
has had in America and we have lost several of our colleagues 
in the epidemic as well.
    As you note, I became our global managing partner in July 
of last year is when I took over----
    Ms. Norton. Is that when you became first aware?
    Mr. Sternfels. That is when I took over this current role 
and I became aware of our staffing, actually, on this 
particular issue with--associated with my responsibilities 
around that time.
    Ms. Norton. Every single one of the 37 FDA contracts 
examined by the committee had at least one McKinsey consultant 
who also consulted for Purdue Pharma on it.
    The committee found at least 22 consultants who worked at 
FDA and opioid manufacturers since 2008. On one project in 
2011, McKinsey consulted for an FDA office responsible for 
multiple drug safety matters on setting that office's 
priorities for, and I am quoting, ``strategic goals and 
priorities'' and asked McKinsey to help weigh--again, I am 
quoting--``the adverse impact of drugs on health in the U.S.'' 
At least four non-McKinsey consultants worked on the same 
contract--on this contract and worked for Purdue at the same 
time.
    Mr. Sternfels, are there today consultants working on 
Federal Government contracts who are also working for private 
sector clients with business before those agencies?
    Mr. Sternfels. Congresswoman, I am aware that we have some 
subcontracts in place today with the FDA, for example. I am not 
aware if any of the currently staffed members also work in 
industry.
    I will point you to the fact that this notion of conflict 
of interest--I would go to Professor Tillipman--is not rooted 
in the individuals. It is rooted in the nature of the work, to 
quote her own statement, and what we----
    Ms. Norton. Well, will you commit today that McKinsey will 
stop staffing consultants on projects for Federal agents and 
private sector clients with business before those agents--
agencies?
    Mr. Sternfels. I will commit today and remain committed 
that we will not staff on any topical areas that are in direct 
conflict, Congresswoman. That is the nature of OCI FAR.
    We take compliance with that incredibly seriously. We take 
disclosure incredibly seriously, and we will make absolutely 
sure that we comply with all rules and regulations that are 
appropriate with that.
    Ms. Norton. Thank you. I just want to say that just 
yesterday the FDA announced it would not be engaging in any 
further contracts with McKinsey. I encourage all Federal 
agencies to reevaluate whether they should be spending taxpayer 
time on that firm.
    [Pause.]
    Ms. Norton.
    [Presiding.] The gentleman from Wisconsin, Mr. Grothman, is 
recognized for five minutes.
    Mr. Grothman. Thank you. I would like to thank the 
committee chairman for having this hearing. I don't think we 
can really have too many hearings on the drug companies and 
maybe the excessive influence they have on our bureaucracy.
    We, right now, have in the most recent 12-month period 
110,000 deaths from illegal drug overdoses. I will ask Mr. 
Dhillon could he comment on those deaths and which drugs, in 
particular, you think are responsible for the 110,000?
    Mr. Dhillon. Which drugs are most responsible?
    Mr. Grothman. Yes.
    Mr. Dhillon. Opioids are as a general category. So, that 
would include synthetic opioids such as fentanyl and natural 
opioids such as heroin, and prescription drugs--prescription 
opioids. That group together is responsible for the vast 
majority of the overdoses.
    Mr. Grothman. I am told right now fentanyl is the biggest 
of the bunch. Is that----
    Mr. Dhillon. Absolutely. That is correct.
    Mr. Grothman. And where do those drugs come from?
    Mr. Dhillon. Largely, they come from Mexico. The drugs are 
imported either as fentanyl into Mexico and then brought by the 
cartels across our Southwest border, or precursor chemicals 
come from China into Mexico. The drug cartels then manufacture 
the fentanyl and bring it across the Southwest border.
    Mr. Grothman. OK. I was told by my local DEA guy that he 
thought maybe 100 percent of the deaths in Mexico came from 
fentanyl brought across the southern border. I mean, 540--could 
all 540? But that is what he speculated.
    Mr. Dhillon. Yes, that is probably--I always hate to say--
hesitate to say 100 percent. But there is virtually no, that I 
know of, illicit fentanyl manufacturing occurring in the U.S. 
It is almost entirely in foreign countries and then brought 
into the U.S.
    Mr. Grothman. Could you comment--and I was down on the 
border last week, and it is so frustrating to see 110,000 
deaths and nobody, seemingly, caring very much because you 
would figure as a minimum we would begin to try to cutoff the 
spigot and, actually, things are going the opposite way right 
now.
    We have less drugs being captured because the Border Patrol 
is busy doing other things. Could you comment on our efforts 
being made to stem the tide of drugs across the southern 
border? It seems like--it seems like it goes up 80,000, 90,000, 
100,000, 110,000, the less we guard the border. Could you 
comment on that?
    Mr. Dhillon. Well, I want to say that the men and women of 
the Border Patrol and Customs and Border Protection, I know, 
are doing their very best. They are overwhelmed.
    I view the border at this point as, essentially, an 
unguarded border and the cartels are aware of that. They are 
actually--they actually plan at times to surge migrants to the 
borders so that they can take Customs and Border Protection--I 
am sorry, Border Patrol--off the line.
    So I believe, at this point, large swaths of our Southwest 
border are, essentially, unprotected, allowing for anybody--
drug traffickers, human traffickers, terrorists--to cross our 
border at will and enter into the United States.
    Mr. Grothman. Can you say we, as a government, care about 
the 110,000 who died last year and still have an open border?
    Mr. Dhillon. I believe that once--in my view, establishing 
border policy, immigration policy, one cannot ignore national 
security, and national security, a part of that, is looking at 
how these drug cartels are affecting and killing our citizens.
    So, in my view, it is impossible to have or to have a 
drug--a border policy that doesn't also take into account 
national security.
    Mr. Grothman. Ultimately, people should go to prison or 
suffer some penalty for that, I would think. Some people 
consider sales or trafficking in fentanyl or other deadly drugs 
nonviolent crimes.
    Do you consider that nonviolent?
    Mr. Dhillon. I could not disagree more with that 
contention. You have--over 100,000 Americans were murdered by 
drug traffickers last year. That is violence. Talk to any 
individual who has lost a family member. Look in their eyes and 
you will see the pain. This is a violent crime. This is a--this 
is not a victimless crime. Drug trafficking has created----
    Mr. Grothman. Do you think we should increase the mandatory 
minimums on fentanyl? Right now you have to have more fentanyl 
than heroin to get the mandatory----
    Mr. Dhillon. We absolutely should be increasing the 
mandatory minimum on fentanyl's. I am a firm believer in 
mandatory minimums for drug traffickers and I believe that the 
fentanyl mandatory minimum should be increased. Incarceration 
works.
    Putting drug traffickers in jail works. Right now, we have 
overdose deaths because the supply is high. The only way to 
attack the supply is to seize those drugs and put the 
traffickers in jail.
    Mr. Grothman. Thank you. Final question. There are 
allegations, which I believe, by the way, that the 
relationships between the regulatory agencies and the 
pharmaceutical industries are too cozy and, as the result, 
there are some drugs we are not looking into.
    Do you believe that sometimes the relationship between big 
pharma and the drug companies is too cozy in this country?
    Mr. Dhillon. That is not something that I can actually 
address, sir. I can say that when I was the head of DEA there 
was no cozy relationship between DEA and the pharmaceutical 
companies.
    Ms. Norton. The gentleman's time has expired. Thank you 
very much.
    I call now the gentleman from Georgia, Mr. Johnson, who is 
recognized for five minutes.
    Mr. Johnson. Thank you, Madam Chair.
    Mr. Sternfels, isn't it true that since 2008 the Food and 
Drug Administration has paid McKinsey more than $140 million in 
taxpayer money?
    Mr. Sternfels. We have been serving the Food and Drug 
Administration since that time, Congressman.
    Mr. Johnson. And you have received $140 million over that 
time, correct?
    Mr. Sternfels. I don't know the exact number but it sounds 
about right.
    Mr. Johnson. And, Mr. Sternfels, isn't it also a fact that 
$40 million of those fees came from the FDA's Center for Drug 
Evaluation and Research, which oversees numerous opioid-related 
programs?
    Mr. Sternfels. Congressman, I don't have the splits by 
program. If that is of interest, I am happy to provide that 
back to the committee.
    Mr. Johnson. Sure. Sure. But, I mean, you won't disagree 
with the fact that your firm, McKinsey, took money from the 
FDA's Center for Drug Evaluation and Research, which oversees 
numerous opioid-related programs, correct? You won't disagree 
with that?
    Mr. Sternfels. No, Congressman. I would agree with you that 
we did work on, I think, what is called CDER as the acronym for 
that, and it might make sense to also describe what we actually 
did with CDER because, as I think the committee knows, it 
covers all drugs, not just opioids. We worked on----
    Mr. Johnson. But it does include opioids, though, correct?
    Mr. Sternfels. It does, and we worked----
    Mr. Johnson. And isn't it true, Mr. Sternfels, that at the 
same time that McKinsey was taking money consulting from the 
FDA that McKinsey was also consulting with the opioid 
manufacturers, including Purdue Pharma, Johnson & Johnson, 
Mallinckrodt Pharmaceuticals, and also Endo International, 
correct?
    Mr. Sternfels. We work with a host of pharmaceutical 
companies and----
    Mr. Johnson. At the same time that you were working with 
the Federal Government, correct?
    Mr. Sternfels. We work, Congressman on different topic 
areas.
    Mr. Johnson. Now, Mr. Sternfels, when was it that McKinsey 
first alerted the Federal Government to the fact that you were 
also working with the opioid companies?
    Mr. Sternfels. If you look through the history of our work 
with the FDA in our proposal process, Congressman, we have made 
multiple mentions in our proposals of our experience both in 
the pharmaceutical industry and----
    Mr. Johnson. But when did--when was it--when did you first 
alert the Federal Government that you were working for the 
opioid companies at the same time?
    Mr. Sternfels. I can't point to the first specific 
instance. But I can tell you there were over 40 references for 
one partner in particular about our work with pharmaceuticals 
and over 20 over a period of several years that he had specific 
experience with opioids.
    Mr. Johnson. So, isn't it a fact, though, Mr. Sternfels, 
that while your company was receiving money from the Federal 
Government that it failed to disclose to the Federal Government 
that it was also taking money from the pharmaceuticals? Isn't 
that correct?
    Mr. Sternfels. I think that is incorrect, Congressman, with 
respect. We made very clear that we were working both with the 
industry and with opioids, in particular.
    Mr. Johnson. From day one with the Federal Government you 
are contending that McKinsey let the government know that it 
was also taking money from the pharmaceutical industry?
    Mr. Sternfels. I will figure out if it is from day one.
    Mr. Johnson. From the opioid industry, actually.
    Mr. Sternfels. And, Congressman, if the first date is of 
interest, I will find that. I looked for total references and 
there is many. But I will go back and get you when the first 
date that--and as recently as yesterday we have seen the FDA 
come out on record both about the work that we did with them 
and our relevant experiences in the industry and in opioids. 
So, if it is useful, I will go back and get you the actual 
first date if that is helpful.
    Mr. Johnson. Yes. I would like for you to do that. I would 
like for you to do that. And do you believe it is proper for a 
company--a private company--to contract with the taxpayers of 
America through the Federal Government for money to advise the 
Federal Government on how to combat the opioid epidemic while 
at the same time taking money from the opioid industry to help 
them turbo charge profits? Is that right?
    Mr. Sternfels. I would not--sir, I 100 percent agree that 
would not be appropriate. Our work for the Federal Government 
was not specifically focused on combating the opioid epidemic, 
and if we were working that exact issue on both sides that 
would be a conflict of interest. Hundred percent agree.
    Ms. Norton. The gentleman's time has expired.
    Mr. Johnson. I thank you, and I yield back.
    Ms. Norton. The gentleman from South Carolina, Mr. Norman, 
is recognized for five minutes.
    Mr. Norman. Thank you, Madam Chairman.
    You know, I find it interesting there is not one Democrat 
posing the question to the Biden administration, as you pointed 
out, Mr. Dhillon, who is allowing somewhere close to 540,000 a 
month, which are five football stadiums that whole 79,000 
people, into this country, not knowing where they came from, 
not knowing what they represent.
    There is not one question that has been posed to the Biden 
administration as to why you are not securing the border. There 
is not one Democrat that signed a discharge petition on having 
Title 42 remain in effect. All we need is seven to put it for a 
vote.
    And, you know, we heard Tom Homan, who used to be director 
of ICE, and Mark Morgan, who was head of the Border Patrol, 
give a dark picture for what is happening to this country under 
this administration under his watch, President Biden's watch, 
and what it is doing to the children who, as you mentioned, Mr. 
Dhillon, are dying.
    Do you see the issue that the fentanyl and all the opioids 
coming across are a direct result of the policies of this 
administration?
    Mr. Dhillon. Look, I want to say that I believe that an 
open border allows drug traffickers free rein to bring in any 
drugs or any contraband they want.
    So, any policy that does not secure our border absolutely 
is a policy that is resulting in overdose deaths every day. So, 
sir, to answer your question are the policies of this 
administration allowing drug traffickers to enter into the 
U.S., the answer is yes.
    Mr. Norman. It used to be, under the Trump administration, 
a thousand a day was alarming. Now we are having close to 
585,000 people a month coming into this country and we not 
knowing where they are going, what they are doing.
    What, in your opinion, should be done to stop this?
    Mr. Dhillon. We need to secure the border. We need to do 
two things right away. We need to secure the border so that 
Border Patrol can go back to actually interdicting drug 
traffickers, seizing their drugs, arresting them, and 
prosecuting them.
    We also need to establish a--reestablish our law 
enforcement relationship with Mexico. More than a year ago, the 
Mexican government, essentially, made it impossible for the 
Drug Enforcement Administration to operate in Mexico.
    DEA has--in terms of foreign offices--has the most number 
of agents and offices in Mexico, for obvious reasons. That is 
where the drug traffickers are who are killing our citizens 
every day with their poisons.
    We need to--the administration needs to immediately 
reestablish those relationships. It needs to hold Mexico's feet 
to the fire. It needs to tell Mexico that we will not tolerate 
what is, essentially, looking like a narco state on our 
southern border. We will not tolerate Mexico allowing drug 
trafficking organizations like the Sinaloa Cartel and CJNG to 
pour these deadly drugs into the U.S.
    Those are the first two priorities. There are many other 
things that need to be done but those are the two that need to 
be done immediately.
    Mr. Norman. Well, I have been to the border, as many have. 
I can't--I don't think this President has been to the border. I 
don't think the Vice President has been to the border, other 
than her laughing about it. I don't really see the thought that 
this is a serious situation with this country.
    Do you agree that the Border Patrol agents that I met with 
and others are totally demoralized and totally feel like the 
handcuffs are on them, not on the criminals?
    Mr. Dhillon. Sir, I have not had a chance to visit the 
border and visit with those hardworking law enforcement agents 
along the border since I was the DEA administrator.
    But I have, certainly, read accounts of that and absolutely 
believe that to be the case. I can't imagine how if you joined 
Customs and Border Protection, if you joined Border Patrol, if 
you joined ICE and, basically, your hands are being tied and 
you are not being allowed to do the job that you joined to do 
that your morale is very high. So, I would agree that that is 
the case.
    Mr. Norman. This is a total travesty of this country. It is 
going to be hard to recover from. It is a violation of the 
Constitution. We have got an invasion that is taking place 
right before our eyes and nothing is being done about it.
    And for the four families that are having that dead child 
or that dead relative due to a drug overdose there is simply no 
excuse for. I think----
    Mr. Dhillon. Sir, I would actually point out that during 
the Trump administration we succeeded for the first time since 
1990 in bringing drug overdose deaths down. So, there is hope. 
With the correct policies it can be done. We can succeed at 
bringing these numbers down. We can be successful with the 
right policies.
    Mr. Norman. Thank you for your testimony. I yield back.
    Ms. Norton. I recognize the gentlewoman from Illinois, Ms. 
Kelly, for five minutes.
    Ms. Kelly. Thank you, Madam Chair.
    Mr. Sternfels, I want to ask you about the history of 
McKinsey's work for Purdue Pharma. McKinsey first began working 
for Purdue Pharma in 2004. Is that correct?
    Mr. Sternfels. I think that is about right in terms of 
timeframe, Congresswoman.
    Ms. Kelly. McKinsey had a few engagements with Purdue in 
2004 and 2005, but most of McKinsey's engagements occurred 
after McKinsey reengaged with Purdue in 2008. Is that correct?
    Mr. Sternfels. I think so, and then wound--most of it wound 
down about 2014.
    Ms. Kelly. In 2007, one year before McKinsey reengaged with 
Purdue, the company and three of its executives pleaded guilty 
to Federal criminal charges of misleading doctors and public 
about Oxycontin's addictiveness and its potential to be abused.
    At that point, several states had also sued Purdue for 
misleading claims about Oxycontin's addictive potential and, 
yet, McKinsey's work continued for the next decade.
    According to information obtained by the committee, from 
2008 to 2017 McKinsey had 65 engagements with Purdue Pharma or 
its affiliates. Many of these involved working to increase the 
profitability of Oxycontin.
    During this period, hundreds of government entities sued 
Purdue for its harmful practices. What is more, your 
consultants were tracking those lawsuits for Purdue, one 2017 
presentation to Purdue and, I quote, ``128 lawsuits in Federal, 
state, and local governments filed against Purdue this year,'' 
unquote, and reported that media mentions, and I quote, ``now 
imply that Oxycontin may have been a driver of the opioid 
crisis.''
    Your company was clearly aware of the harm Purdue was 
causing. Did McKinsey ever consider cutting ties with Purdue 
during this period?
    Mr. Sternfels. Well, Congresswoman, thanks for the 
question, and you are right that we had a long history of 
serving Purdue. As you all know, we also exited opioids on our 
own decision in 2019, and I have apologized--and you heard my 
opening statement--for our work with Purdue and other opioid 
manufacturers.
    We fully recognize that it fell short of our standards and 
it is why we pivoted to settle with the states and spend over 
$575 million on prevention and treatment.
    So, we are all in in being part of the solution, going 
forward. You know, I think the root of this is while our intent 
was not to fuel an epidemic in any of our work, I think we 
failed to recognize the broader context of what was going on in 
society around us and that is why we put new policies and 
protocols into place to prevent this kind of stuff from 
happening again.
    Ms. Kelly. All righty. It wasn't until more than a decade 
after reengaging with Purdue to boost sales of Oxycontin and 
after making untold millions of dollars in consulting fees for 
this work that McKinsey issued a public apology for its role in 
finding--in fueling the opioid epidemic, as you have just said.
    But for over a decade, McKinsey advised Purdue on how to 
boost sales of Oxycontin while tens of thousands of people were 
dying each year from opioid overdoses.
    It is time for accountability and transparency. The 
American people deserve the truth about your company's role in 
this epidemic.
    And I yield back.
    Ms. Norton. The gentlelady yields back.
    I recognize the gentleman from Texas, Mr. Cloud, for five 
minutes.
    [No response.]
    Ms. Norton. I move on, therefore, to recognize the 
gentleman from Louisiana, Mr. Higgins.
    Mr. Higgins. Thank you, Madam Chair. Thank you for holding 
this hearing. I am going to try and bring some perspective to 
this conversation--the street perspective, my perspective.
    Louisiana overdose deaths have increased since 2018--just 
some specific numbers--from 1,065 in 2018 to 1,926 in 2020, 
virtually doubled overdose deaths. But the opioid crisis in 
America is constantly a moving target for law enforcement and 
this committee should be focused on the actual challenges that 
America faces right now.
    McKinsey, obviously, was involved in gray areas and, 
arguably, criminal areas of their interaction with the opioid 
disbursement across the country, and they are being held to 
account. They have settled with 49 or 50 states and we should 
acknowledge that as a committee and move on to the actual 
threat to our country, which is fentanyl pouring over the 
border.
    Over the course of the last 30 years, the opioid threat has 
changed. Back in the mid 1990's, Oxy showed up in street with 
the street names Percs, 512, OC. My DEA friend will know this. 
Oxy showed up. It was very powerful and it was frightening.
    By 2007 or so, Oxy was moved aside by Hydrocodone, Lortabs, 
Hydro tabs. Lortabs were horrible. They were available like 
candy on the street. It was very easy to get a prescription. 
So-called pain management was the destruction of untold scores 
of thousands of American families. Each one had a story.
    In 2009 as a street cop, I welcomed a new resident to our 
community. That was a regular part of being a good cop. 
Somebody moves in, you get down and talk to them. A lady moved 
into a single-wide trailer with her adult daughter and her 
granddaughter. The family seemed very happy for a while. I kept 
an eye on the family.
    But over the course of about a year, things started to go 
wrong, and I knew that it was about drugs and I knew that it 
was about Lortabs. And I watched that family disintegrate. The 
daughter left with the granddaughter. Couldn't deal with the 
mother anymore. The mother was addicted. I had to take her dog 
away from her because she was abusing her dog. She was 
spiraling downwards further and further.
    One night I got a call from the daughter through the police 
department. They dispatched me to the house. She hadn't been 
able to reach her mother. This is one story--one story, 
America. Pay attention, because this story is multiplied by the 
millions across our country. The daughter calls. She couldn't 
reach her mom.
    I got to the house. I couldn't get in. I didn't have a 
warrant but I kicked the door. Her grandmother laying there 
dead, empty bottle of Lortabs in a filthy single wise. She died 
in squalor and filth, dead by tabs. This story is multiplied 
again and again in my career. Every cop knows this story.
    By 2014 or so, Lortabs were gone. The laws were changed up 
here in this body. The schedule was changed on that drug. 
Doctors started restricting the prescription.
    It was in that era I suppose McKinsey was responsible for 
what they were responsible for and they have been held to 
account. But it is our southern border right now where fentanyl 
is pouring across into our country. Leading cause of death, my 
God, and we are not discussing the border in this committee?
    Americans are dying. Fentanyl is 80 to 100 times more 
powerful than morphine. A backpack of that junk will kill a 
whole city. It is pouring into our country directly as a result 
of the policies coming out of our own White House.
    Our own White House is killing Americans with fentanyl 
pouring across the border. We want to talk about litigation and 
settlements from McKinsey, a company that had to deal with 
pushing RX drugs. They should be held to account but they are 
being held to account. That is the American way. This committee 
should be focused on the existing threat.
    Madam Chair, I yield.
    Ms. Norton. I now recognize Mr. Krishnamoorthi, the 
gentleman from Illinois, for five minutes.
    Mr. Krishnamoorthi. Thank you, Madam Chair.
    Mr. Sternfels, I wanted to draw your attention to a 
different topic, namely, JUUL Labs and vaping. There are two 
complaints I have before me, one by the Alaska attorney general 
against JUUL from 2020, as well as another complaint filed by 
the city and county of Denver, Colorado, against the same, 
along with some other defendants. McKinsey is not one of the 
defendants but it is mentioned within each of these complaints.
    I will draw your attention to paragraph 155 of the Alaska 
complaint, in which it says that in 2018, at least as of 2018, 
McKinsey and Company had been retained by JUUL Labs to conduct 
some market research with regard to e-cigarettes and teen 
preferences with regard to e-cigarettes. You don't have any 
evidence to dispute this particular fact, correct?
    Mr. Sternfels. Congressman, what I do know is that we 
stopped all work for vaping and that from my understanding our 
work with JUUL was actually focused on youth prevention while 
we worked with them, and with our new client framework that I 
had mentioned earlier this ended up saying, look, what is going 
on in society means that we shouldn't actually be doing work in 
vaping.
    Mr. Krishnamoorthi. So yes, there was an engagement with 
JUUL at least through 2018 under the topic heading, largely, 
youth e-cigarette prevention. Let me just go over some of the 
work that was done.
    In paragraph 156 of this complaint it says that McKinsey 
and Company surveyed teens aged 13 to 17, generating over 1,000 
responses and as part of that survey that McKinsey conducted it 
found that teens co-favorite flavors were mango and mint. You 
don't dispute those findings, correct?
    Mr. Sternfels. What I--I don't dispute the findings, 
Congressman. What I understand was that work was to then 
exclude those flavors to drive youth prevention, at least my 
understanding of the work.
    Mr. Krishnamoorthi. Well, let me just tell you what JUUL 
ended up doing with that conclusion. In November 2018, the FDA, 
basically, warned JUUL that it has to stop selling flavored e-
cigarettes because those flavored e-cigarettes are what hooked 
young people onto vaping.
    JUUL decided that they would stop selling all flavors 
except mint e-cigarettes, possibly because they found that one 
of the co-favorite flavors that teens had identified in your 
survey was mint.
    I presume that you would have counseled them to stop 
selling mint e-cigarettes, correct?
    Mr. Sternfels. Congressman, I am not an expert on flavors 
of vaping. What I can tell you as a father of three teenagers I 
am 100 percent in agreement about the concerns around vaping, 
particularly for youth.
    I do know that our work was focused on making 
recommendations around youth prevention.
    Mr. Krishnamoorthi. I guess what I am saying, Mr. 
Sternfels, is if your findings identified that mango and mint 
flavors were teenagers' co-favorite flavors as part of your 
survey and you had been engaged to prevent vaping among youth, 
I presume that you would have counseled JUUL not to sell mint 
e-cigarettes following the conclusions of your survey, right?
    Mr. Sternfels. I am not familiar with our specific 
recommendations, Congressman. I do know that part of the reason 
we decided to exit the category entirely was the belief that 
even our work focused on youth prevention was not having the 
effect in the broader society that we envisioned by the exit.
    Mr. Krishnamoorthi. Let me jump in for one second, Mr. 
Sternfels.
    No, I am sorry for interrupting. I just have limited time. 
I would respectfully request that you and McKinsey please 
produce this particular survey along with your recommendations 
coming out of this survey, because it is very important to my 
investigation as chair of the Economic and Consumer Policy 
Subcommittee into the youth vaping epidemic.
    I should tell you that following our investigation the 
Trump administration then banned these flavors except for 
menthol and tobacco flavored e-cigarettes. Mint and menthol are 
extremely close in taste preferences among youth.
    And so I would--can you commit to producing those documents 
to us? Or should I just commend you for focusing in on this 
area?
    Mr. Sternfels. Well, Congressman, I just commend you for 
focusing in on this area. As you heard me, I am equally worried 
as a father of three teenagers on this, and I would be happy to 
work with you following up on what your specific questions are 
with respect to vaping to help answer any questions you may 
have after the testimony today.
    Mr. Krishnamoorthi. OK. Thank you.
    Ms. Norton. The gentleman's time has expired.
    I recognize the gentleman from Texas, Mr. Cloud, for five 
minutes.
    Mr. Cloud. Thank you, Ms. Chairman.
    Last term, we had seven hearings on the border in this 
committee hearing. We have seen videos of the majority members 
now who were at the border crying tears. Today, we are here to 
talk about an opioid epidemic while the number-one killer in 
the United States among young people is fentanyl.
    I am from south Texas and so regularly I hear stories from 
farmers and ranchers. I just left a meeting with farmers and 
ranchers to come here. I will constantly hear about their 
fences being run over from bailouts.
    We hear from families who are afraid to let their children 
roam their own property because of what is going on. We hear 
stories of rape trees found on properties. I visited the 
facilities where a young woman--over 50 percent of them will 
admit to being abused along the journey.
    And just recently, we had a Texas National Guard member, 
Bishop Evans, who drowned while trying to save what he thought 
was some migrants who were trying to make their way here and it 
looks more now like they were trafficking drugs into our 
country. Yet, this committee refuses to have a hearing on this.
    Mr. Dhillon, you mentioned that under the Trump 
administration something happened with the drug overdose issue 
in our country, which was remarkable, actually, historically. 
Could you speak to that?
    Mr. Dhillon. I believe it was in 2018 we saw drug overdose 
deaths reduced for the first time--decreased for the first 
time, a little over 4 or 5 percent, and that was the first 
reduction that we saw, I believe, since 1990 and I believe that 
was as a result of the aggressive policies.
    And I am here talking mostly about enforcement but it is 
also to remember that prevention and treatment are absolutely 
critical in fighting the overdose crisis, and during the Trump 
administration we took that three-pronged approach.
    We prioritized prevention. We prioritized treatment and we 
prioritized enforcement, and I believe that was why we saw 
overdose deaths dip that year. The same aggressive approach, 
again, with enforcement, which has to be an important part of 
that to reduce supply, I think, could also have a similar 
effect.
    Mr. Cloud. You mentioned prevention and enforcement. Would 
you connect the enforcement that happened at the border as a 
prevention mechanism? I mean, would you say the data suggests 
that there was a connection?
    Mr. Dhillon. When we talked about prevention we usually 
talked about education.
    Mr. Cloud. Sure.
    Mr. Dhillon. Taking drugs is bad. In my day, it was this is 
your brain on, you know, the fried egg.
    Mr. Cloud. Right. The frying pan, yes.
    Mr. Dhillon. Yes. So but, yes, prevention in the sense that 
preventing drugs from coming into the U.S. I describe that as 
the supply issue. One of the things we learned from the opioid 
crisis is that supply matters, that an increase in supply 
results in an increase in overdose deaths.
    So, enforcement is the only way you can attack supply so 
enforcement has to be a critical part of that, which means the 
only way to keep supply down is to stop those drugs from coming 
across our Southwest border and a secure border is absolutely 
critical to that.
    Mr. Cloud. Now, you mentioned Mexico. It was interesting 
the term you used--I have thought of it before but I don't hear 
the term much--as becoming a narco state. Could you speak to 
that a little bit?
    Mr. Dhillon. Well, so the government designates certain 
countries as a narco state. I am not saying that the government 
has done that. But what I am saying--that the U.S. Government 
has done that.
    Mr. Cloud. Sure.
    Mr. Dhillon. But what I am saying is that the way Mexico is 
now treating drug traffickers, in my view, not harshly at all--
--
    Mr. Cloud. Right.
    Mr. Dhillon [continuing]. that its failure now, its 
affirmative efforts to undo the cooperation--the law 
enforcement cooperation between the U.S. and Mexico is, 
effectively, turning Mexico into a narco state.
    Mr. Cloud. Right.
    Mr. Dhillon. There were swaths of Mexico, parts of the 
country, that are completely controlled by drug traffickers.
    Mr. Cloud. Controlled by drug traffickers.
    Mr. Dhillon. So, we need to recognize the national security 
risk of an open border. We have what is verging on a narco 
state on our southern border.
    Mr. Cloud. And what is interesting about that is we are 
beginning to see certain communities even in California that--
where cartels are beginning to take over certain communities 
and we are seeing that now being established, albeit in 
pockets, but here in the United States as well.
    The Biden administration policies have--their open border 
policies have created a reversal of this trend for sure. Right 
now, the big issue, of course, in the public sphere is Title 42 
and there is an understanding that that would--I have been to 
the border several times over the last year--that that is like 
the last thing holding together any shred of security.
    Now, we understand that Nancy Pelosi doesn't want to bring 
a Title 42 bill to the floor. But I will say this. There is a 
mechanism, a discharge petition. We need seven more Democratic 
members to support in order for us to force a vote on the Title 
42 bill, and I would encourage the members of this committee, 
15 of which who said we needed to repeal Title 42 Because of 
the false story about Border Patrol members riding horses 
whipping migrants. Fifteen members of this committee----
    Chairwoman Maloney.
    [Presiding.] The gentleman's time has expired.
    Mr. Cloud [continuing]. supported that. I would encourage 
you to reverse course and support this discharge petition.
    Thank you. I yield back.
    Chairwoman Maloney. The gentleman yields back.
    The gentleman from California, Mr. DeSaulnier, is 
recognized for five minutes.
    Mr. DeSaulnier. Thank you, Madam Chair, and thank you for 
your tenacity on this subject. It is so important. It is hard 
to believe that we could hear and have another hearing that 
would be worse in terms of business behavior than the one we 
had with the Sackler family and Purdue Pharma. It is very, very 
upsetting to hear this testimony. The company, McKinsey, that I 
used to respect I can't imagine having anyone--my children 
working for McKinsey, Mr. Sternfels.
    Ms. Feiner, congratulations to you and the attorney general 
for your--makes me proud of being a native of Massachusetts. 
Let us talk a little bit about what you uncovered about the 
communication of trying to cover up the actions by McKinsey.
    In 2018, an investigation on Purdue began closing in on 
McKinsey. Their employee, Martin Elling, a partner at McKinsey, 
emailed another partner to ask if we should do anything, quote, 
``other than eliminating all our documents and emails.''
    A month later, Mr. Elling emailed himself a note to, quote, 
``delete old Pur documents from a laptop,'' Pur referring to 
Purdue Pharma.
    Ms. Feiner, did you uncover evidence in your investigation 
that McKinsey consultants may have taken even additional steps 
to hide or cover up their actions?
    Ms. Feiner. Thank you for your question.
    Yes, we did uncover documents about obstruction, deleting 
emails and documents relating to McKinsey's work for Purdue, 
and because they discussed destroying evidence right after we 
filed our lawsuit we included a term in our judgment requiring 
McKinsey to automatically preserve every email or instant 
message by every McKinsey employee working on any matter 
anywhere in the world.
    People at McKinsey and at other companies engaged in this 
type of conduct, this reprehensible conduct, should know when 
your company and your executives do something that you don't 
want uncovered, the right answer is not to do it. No one should 
think that they will be allowed to hurt people and keep it 
secret.
    And one astonishing fact that we uncovered is that there 
were people inside of McKinsey who saw these red flags. They 
saw these conflicts and they said, you know, we should be 
treading carefully here.
    There are conflicts between industry, our industry clients 
like Purdue, and our regulator clients, and they went ahead and 
they changed recommendations in documents anyway.
    Conduct like this should never happen, especially when it 
affects American lives, and that is why we banned McKinsey from 
the opioid business forever, and I am pleased to hear today 
that they are no longer working for JUUL.
    I think that those kinds of changes and conduct are the 
results of this committee's efforts and our office's efforts 
and I think that we are on the right track.
    We have to protect American lives. That is our job. Thank 
you.
    Mr. DeSaulnier. Thank you. And you heard the comments by 
the managing partner of McKinsey earlier about things being 
taken out of context. Can you--based on your investigation, the 
overall theme of McKinsey's irresponsible behavior, how do you 
respond to what I take as obfuscation?
    Ms. Feiner. Yes, I agree with you that there is definite 
obfuscation here. I mean, just look at the types of 
recommendations that they were making to Purdue at the height 
of this crisis when thousands and thousands of Americans were 
getting sick from the disease of addiction and dying.
    They were working with companies like Purdue, like Johnson 
& Johnson, to turbo charge opioid sales. That is the height of 
irresponsibility, at a time when they were also working inside 
the FDA learning how that agency worked and trading on their 
relationships and their insider knowledge to get their private 
clients.
    Mr. DeSaulnier. The testimony today strikes me as 
encouraging the continued behavior or at least defending it, 
making light of that behavior in spite of the apology.
    Ms. Feiner. I think that this is par for the course with 
companies that engage in misconduct like this. I mean, it is 
not surprising to hear that their answers today are defensive.
    I think the real thing that this committee is doing and our 
investigation did is to look at what they were saying at the 
time that they were engaging in this conduct, and those actions 
and those words speak volumes.
    Mr. DeSaulnier. Mr. Sternfels, have you done a 
comprehensive analysis of what communication happened within 
the company and will you turn any of that over to the committee 
as the chairman has suggested?
    Mr. Sternfels. Congressman, we have done a comprehensive 
analysis of the communications and document retention and the 
policies associated with that are absolutely critical to us. It 
is why that the two colleagues that you made mention of were 
terminated as soon as we actually realized that they violated 
our document retention policy. And if that--areas of further 
interest----
    Chairwoman Maloney. The gentleman's time has expired, 
regretfully.
    OK. Now we recognize the gentleman from Pennsylvania, Mr. 
Keller. You are recognized for five minutes.
    Mr. Keller. Thank you, Chairwoman Maloney, Ranking Member 
Comer, and I would like to thank our witnesses for being here 
today.
    The opioid epidemic is an issue that continues to affect 
millions of Americans. CDC reports that last year from April 
2020 to April 2021 there were 100,000 deaths caused by 
overdoses and three-quarters of those were due to opioids.
    Clearly, it is a devastating problem that is happening and 
it deserves congressional attention. But it is not a stand-
alone problem. President Biden and my colleagues on the other 
side of the aisle refuse to address the glaring source of 
illicit drugs in our country, the unsecured southern border.
    In Fiscal Year 2021, Customs and Border Patrol seized 
11,000 pounds of fentanyl at our southern border. That is 
enough to kill two and a half billion people. Think about that.
    The amount of fentanyl that would have flooded American 
communities without CBP intervention would have been sufficient 
to kill one-third of the Earth's population. DEA issued its 
first public safety alert in six years, warning the public 
about fentanyl-laced prescription pill lookalikes. And we heard 
what had happened in 2018 when we saw the first reduction in 
overdoses and I think that is partly due, as was mentioned by 
my colleagues, to the fact that we were taking the security of 
our southern border seriously during the Trump administration.
    So, Mr. Dhillon, as a former DEA acting administrator, how 
do you think the current situation at the border is affecting 
the DEA's ability to keep life-threatening substances off our 
streets?
    Mr. Dhillon. It is making it very difficult. Again, if you 
combine the efforts of Mexico to, essentially, make it 
impossible for DEA to operate there, an open border, you are, 
essentially, forcing DEA to fight the battle against the drug 
cartels on our home turf.
    So, that means the DEA is only able to really attack drug 
traffickers now once the drugs get into the U.S. and you are 
going after the traffickers here locally.
    Extraditions over the last year of drug traffickers from 
Mexico has decreased significantly. During the Trump 
administration, we had a number of extraditions from Mexico for 
wanted drug traffickers. That has ended.
    So, that means we can't even prosecute drug traffickers in 
Mexico because we--even if we could collect the evidence, which 
we can't now because of the poor relationship that Mexico has 
created with U.S. law enforcement, we can't even get them here 
because the Mexican government isn't expediting them.
    So, the job has become astronomically higher, I think, for 
all drug and law enforcement in the U.S.
    Mr. Keller. OK. So, I guess I would ask, what would you 
recommend government--what actions should we take as government 
officials to help the DEA in its mission to stomp out illicit 
substance trafficking at our southern border?
    Mr. Dhillon. Well, I think from a policy perspective, 
securing the border is the first thing. That is where the drugs 
are coming from. So, that is--it is just common sense that we 
need a more secure border.
    But we also need to take the battle to the drug traffickers 
where they live, which means DEA needs to be able to work 
effectively with Mexican law enforcement in Mexico where we can 
work with them to go after drug labs there, which DEA has done 
in the past, where we can collect evidence against high-level 
drug traffickers in the cartels.
    We can then give that evidence to U.S. Attorneys here in 
the U.S. who can indict them, and then we can seek extradition.
    Pressure needs to be put on Mexico to reengage the U.S. in 
a cooperative manner to allow us to do our jobs there.
    Mr. Keller. Thank you. I appreciate that, and it is a 
serious issue and there is many serious issues. I heard my 
colleagues talk about vaping and other things, which, again, 
are serious issues. But we talk about these things and then we 
just voted on a bill to legalize marijuana for recreational 
use.
    I mean, really, we need to get serious if we are concerned 
about addiction. Addiction is a health epidemic and we need to 
make sure we are treating it that way, not making more drugs 
available and making it easier to have that happen.
    So, if my colleagues on the other side of the aisle are 
serious about addressing the opioid crisis, then they should be 
serious about securing our southern border.
    Thank you, and I yield back.
    Chairwoman Maloney. The gentleman yields back.
    The gentlelady from Michigan, Ms. Tlaib, is recognized for 
her five minutes.
    Ms. Tlaib. Thank you so much, Chairwoman.
    Hey, Bob, do you know what the term hyperbolic means?
    Mr. Sternfels. No. Can you help me?
    Ms. Tlaib. Yes. Oh, I am going to show you an example 
actually.
    So, Bob, you know, in 2020, after McKinsey's work for 
Purdue Pharma came to light your firm admitted that it, quote, 
``did not adequately acknowledge that the epidemic unfolding in 
our communities or terrible impacts of opioid misuse and 
addiction on millions of families across the country.'' Like, 
you just didn't--did not adequately acknowledge. OK.
    So, then the committee, of course--the great work of the 
committee continued their investigation and found that McKinsey 
didn't just fail to acknowledge the severity but behind closed 
doors your staff, your team, routinely just went through this 
whole disregarding all the information that was coming very 
clearly to you all in regarding the mass poisoning in the first 
place.
    So, I would like to put up an email, in 2018 an email where 
McKinsey's government-facing practice discussed how a senior 
partner at McKinsey who served opioid manufacturers viewed the 
situation.
    [Screen.]
    Ms. Tlaib. The person wrote, quote, ``told me the word 
epidemic and/or crisis are hyperbolic.'' OK. So, Bob, this--you 
know, it means marked by language that exaggerates or 
overstates the truth.
    So, fair question, Bob. More than half a million people in 
the United States have died of opioid overdoses in 1999. Do you 
agree, yes or no, that calling a half a million deaths an 
epidemic or crisis is hyperbolic?
    Mr. Sternfels. I am still a little confused on the 
question. I think half a million is catastrophic.
    Ms. Tlaib. That it is exaggerated--that you literally are 
saying half a million that is just an exaggeration, that it is 
not a crisis to have a half a--you know, literally, a half a 
million people died of opioid overdose. That is what you all 
said in an email.
    Mr. Sternfels. I have been clear, Congresswoman, that we 
view it as an epidemic.
    Ms. Tlaib. OK. We have the email, Bob.
    OK. For 15 years, you all know, the strategy of McKinsey, 
Bob, was routinely used to have sales and marketing 
representatives targeting doctors who wrote, you know, high 
numbers of prescriptions and including those that ran so-called 
pill mills.
    I mean, to me, that is trafficking, correct? Aren't you 
guys trafficking?
    Mr. Sternfels. I wouldn't say that our work on any aspect 
of sales and marketing is trafficking, Congresswoman.
    Ms. Tlaib. Yes. I know you all wear suits and everything 
and you don't consider yourself drug traffickers. But let me 
give you some information here.
    When the FDA announced new restrictions on opiates in 2013, 
including a, quote, ``boxed warning for pregnant women'', 
McKinsey consultants at Purdue had doubts that this warning 
would even change the behavior of high-prescribing doctors and 
emailed each other about the safety concerns.
    So, I would like to put one such email up on the screen.
    So Laura, on your team--she is a principal at the firm--she 
said, ``I am most curious to see if high writers even notice 
this. Smiley face.''
    So, Bob, I think it is safe to assume that, quote, ``high 
writers'' were--refer to prescribers that were writing high 
numbers of prescriptions for opioids. Would you agree?
    Mr. Sternfels. If you can give me a second just to read 
that the email, Congresswoman. I just see it up on the screen 
here.
    Ms. Tlaib. I mean, those are, like----
    Mr. Sternfels. I get--yes. Sorry.
    Ms. Tlaib. Those were the exact prescribers McKinsey was 
advising Purdue to target, correct, in order to turbo charge 
sales?
    Mr. Sternfels. From my understanding, this email chain 
refers to how we could help Purdue comply with new FDA 
restrictions. I completely agree that a smiley face is totally 
inappropriate. But I think this chain----
    Ms. Tlaib. Yes. Yes. Well, you guys are trafficking. You 
are making money off of poisoning people. So, why do you think 
your employee--you think it is fun? Why do you think your 
employee would even put a smiley face next to a question of 
whether or not high writers would notice a black box warning--
literally, a warning had been put on the Oxycontin for pregnant 
women?
    Mr. Sternfels. I can't guess as to why there was a smiley 
face. I do know this string relates to how we help Purdue 
comply with that--with new FDA regulations.
    Ms. Tlaib. No. You all were happy to think that this 
warning wasn't going to derail McKinsey's pill-pushing schemes, 
you know, trafficking the drugs while McKinsey was celebrating 
its blood money, communities were being torn apart.
    You know, Bob, 86 percent of overdoses in my district in 
the city of Detroit were due to overdoses from opiate. Did you 
know that?
    Mr. Sternfels. I did not know that stat. I know that there 
have been many.
    Ms. Tlaib. Do you know behind that number--behind that 
number was a human being, Bob? Do you understand, like, if 
anyone could explain me the difference between McKinsey big 
pharma opioid cartel and the organizations of people like Pablo 
Escobar, I am all ears. I really am.
    You all may be wearing suits and you may be having these 
fancy offices but you are doing the same freaking thing.
    Thank you so much.
    Mr. Comer. Would the lady yield to a question?
    Chairwoman Maloney. Her time has expired and we are trying 
to keep on record.
    Mr. Fallon from Texas, please.
    Mr. Fallon?
    Mr. Fallon. Thank you, Madam Chair.
    Today, the majority party wants to discuss the business 
practices and conflicts of interest of McKinsey and Company. 
Well, that is all well and good. I have been here a year and a 
half and we haven't talked about having a hearing about the 
southern border at all.
    What we should also be talking about is the business 
practices and conflicts of interest of some Members of Congress 
who choose to shamefully and blatantly ignore the root causes 
of 100,000 American deaths, our fellow citizens, due to drug 
overdoses, 75 percent of which are opioid overdoses.
    And, now, where do these drugs come from? How do they get 
here and who is responsible for bringing them?
    Today what we really should be talking about--or if we 
don't do it today we should have a hearing about it, 
certainly--it has been a year and a half--discussing, some say, 
the border crisis. It is not even a crisis anymore.
    We are talking about a border catastrophe, and if these 
trends continue it is going to be cataclysmic. The border 
crisis catastrophe and cataclysmic events that are going on are 
responsible for 100,000 of our citizens' deaths.
    In 2021, the DEA in Phoenix, Arizona, alone seized 9.5 
million fentanyl-laced pills that were designed to look like 
prescription drugs. In Fiscal Year 1921, U.S. Customs and 
Border Patrol seized 11,000 pounds--over 11,000 pounds of 
fentanyl, which is enough to kill every American eight times 
over. We keep hearing that but let that sink in.
    In Fiscal Year 1921, almost 200,000 pounds--or sorry, 
200,000 pounds of methamphetamine was seized. Now, the Mexican 
drug cartels are making wild profits, record profits, in fact, 
and it is not just with narcotics smuggling but with the 
smuggling of human beings.
    We talked to Customs and Border Patrol a few weeks ago and 
they told us that the cartels are charging $4,000 a person, and 
in March there was 221,000 known illegal border crossers, about 
60,000 to 70,000 known got aways.
    So, you are bordering on a number here of about 300,000. 
You do the math on that, that is a billion dollars in a month 
and the estimates are that the drug cartels' GDP is somewhere 
between $15 billion and $25 billion on the narcotics end. But 
that is making about $10 billion to $15 billion just on 
smuggling human beings.
    And the answer is not to sit there and obfuscate and ignore 
and be an ostrich and put your head in the sand. We had the 
Homeland Security Director Mayorkas last year say in front of a 
committee that the border was secure, and then he gets caught 
on a hot mic a few months later saying that it is chaos.
    So, which one is it? Because is that hyperbole or is that a 
lie? So, the crisis isn't getting better, by the way, just 
because the media doesn't cover it. It is not getting better. 
It is getting worse.
    Mr. Dhillon, a question for you. Where is the majority of 
the fentanyl that gets into this country--where is it produced? 
What country makes it?
    Mr. Dhillon. It comes from Mexico. It is either produced in 
Mexico or it is trans shipped from China to Mexico and then----
    Mr. Fallon. So, China.
    Mr. Dhillon. But the bottom line is it all ends up in 
Mexico, by and large, and then comes across our Southwest 
border.
    Mr. Fallon. Right. So China, obviously, no friend of the 
United States--our biggest foe and I think we would all agree 
our greatest threat, moving forward.
    Methamphetamine--where is most of that produced?
    Mr. Dhillon. Mexico. Meth labs are rampant in Mexico. Super 
labs.
    Mr. Fallon. So, the high-tech labs that we saw, like, on 
``Breaking Bad,'' you know, that were underground, they are in 
Mexico, right? I mean, those really exist.
    Mr. Dhillon. As the acting administrator of the Drug 
Enforcement Administration, I visited one of those labs in a 
jungle. They exist and they produce enormous amounts of 
methamphetamine. That technology can be applied to fentanyl. 
So, I would anticipate that the cartels are already doing that.
    Mr. Fallon. Yes, they are going to cut out China and they 
will just make it there. More money to be made? How does the 
majority of these drugs that are killing our fellow citizens 
get to this country? Is it by air, is it by land, or is it by 
sea?
    Mr. Dhillon. It is by land across the Southwest border.
    Mr. Fallon. The southern border.
    So if--as Americans, if we are not safe, then we are not 
free, and what we need to be doing is ensuring that we use 
Title 42 as a tool to secure the border and reimplement the 
migrant protection protocols that worked magnificently when 
President Trump was able to turn this flood into a trickle, and 
now, unfortunately, it is a flood again.
    Support legal migration by deporting criminals and building 
walls and other barriers with gates. Because this isn't about 
migration. There is going to be migrants coming this country 
and there should be. But we want to support legal migration and 
oppose with every fiber of our being illegal migration.
    And it shouldn't be a partisan issue. It is. I don't know 
why. But we are going to find out in November what the American 
people think about this.
    Thank you very much, Madam Chair, and I yield back.
    Chairwoman Maloney. The gentleman yields back.
    I now recognize the gentlelady from Missouri. Ms. Bush is 
recognized for five minutes.
    Ms. Bush. St. Louis and I thank you, Chairwoman Maloney, 
for convening this timely hearing.
    My hometown in St. Louis ranks among the deadliest cities 
in the country for overdose deaths among Black people. Just 
last week, the University of Missouri, St. Louis, released data 
that showed opioid-overdose deaths among Black people in St. 
Louis, city and county, increased by 560 percent in the last 
six years; 560 percent in six years alone.
    As a nurse, I am heartbroken by this preventable, 
preventable, totally preventable loss of life. And as a 
Congressman, I am outraged.
    We are demanding answers from one of the most evasive and 
secretive consulting companies in the world, McKinsey & 
Company. They have worked for and advised both, opioid 
manufacturers like Purdue and the Federal agency responsible 
for regulating them, the FDA.
    Over the span of 15 years, McKinsey raked in nearly $1 
billion in government contracts; contracts that included 
assisting the FDA in determining who drugs are safe. At the 
same time, they would make untold millions more consulting with 
companies like Purdue to help them exploit regulatory loopholes 
at the FDA.
    There are dire implications of private corporations 
crafting public policy behind closed doors. And the process of 
discovering the extent of McKinsey's role in fueling the opioid 
crisis, lawmakers have an obligation to call for both, 
accountability and justice, transparency and honesty, and 
apology and reparations.
    The families and friends of the nearly 500,000 people who 
have died from an overdose since 1999, they deserve answers. 
Congress deserves answers. And those who died or whose lives 
have been destroyed because of opioids, deserve accountability.
    Mr. Sternfels, please respond yes or no, just simply yes or 
no, is McKinsey required to disclose current or potential 
conflict of interest when bidding for government contracts?
    Mr. Sternfels. We are, ma'am.
    Ms. Bush. Thank you.
    And another yes-or-no question, was it a conflict of 
interest to consult with the FDA about the safety of drugs like 
OxyContin, while also profiting from OxyContin through Purdue?
    Mr. Sternfels. We did not comment on the safety of drugs, 
such as OxyContin or any other drug in our work with the FDA.
    Ms. Bush. Is your company willing to submit documentation 
to the committee, confirming that McKinsey's relationship with 
Purdue was not a conflict of interest?
    Mr. Sternfels. We have been very transparent with this 
committee, Congresswoman, on both, our work with Purdue and we 
are happy to provide any more transparency around that, and 
also with our work with the FDA. And so, if there are any 
questions around either side on that, Congresswoman, I am happy 
to work with you to provide it.
    We believe in transparency on both those. I know you said--
--
    Ms. Bush. Thank you.
    Mr. Sternfels [continuing]. we didn't, but we do.
    Ms. Bush. So, I will take that as a yes, that you will be 
willing to submit documentation to the committee, confirming 
the relationship was not a conflict of interest. Thank you so 
much.
    Ms. Feiner, when OxyContin sales were low, McKinsey advised 
Purdue to send its sales representatives to, quote, high-decile 
prescribing physicians. Purdue adopted this advice.
    Ms. Feiner, why would McKinsey have advised Purdue to 
target these physicians?
    Ms. Feiner. Thank you for your question.
    McKinsey did a lot of work with the data and found out, and 
sold advice to Purdue, that the highest decile prescribers were 
the most likely to write more OxyContin prescriptions and that 
is the same advice that they sold to Johnson & Johnson.
    You know, 25 times more than their counterparts, those are 
the doctors that McKinsey was sending Purdue sales reps to 
visit relentlessly, 25 times more than their counterparts, 
because they were the most profitable targets. They didn't care 
whether those doctors were writing safe prescriptions and, in 
fact, looking at the data, you know, the odds were that they 
weren't. Purdue paid its sales reps to visit these doctors over 
and over again.
    We tracked every time Purdue visited a Massachusetts doctor 
and every time someone in Massachusetts died of an overdose, 
and we found that Purdue's top targets were at least 10 times 
more likely to prescribe Purdue opioids to patients who 
overdosed and died.
    The Nation, thousands and thousands of Purdue patients 
overdosed and died. That is why it was so important to us to 
expose McKinsey & Company.
    Ms. Bush. Thank you so much for those insights.
    As a nurse who has seen devastation, the devastation 
opioids have caused in my community, I am deeply troubled by 
these taxes--these tactics. Communities like mine have 
struggled under the deadly and devastating opioid crisis for 
decades, our community criminalized, and companies like Purdue 
and their consultants, like McKinsey, enrich themselves in 
billions.
    Chairwoman Maloney. The gentlelady's time has expired.
    Mr. Connolly. Will the lady yield to a question?
    Chairwoman Maloney. The gentleman from Florida, Mr. 
Donalds, is now recognized for five minutes.
    Mr. Donalds. Thank you, Madam Chair.
    We are wasting more time in Congress. This hearing, 
although the opioid epidemic from pharmaceutical manufacturers 
in the United States was a serious problem in our country for a 
period of time, many states, like my state of Florida, like the 
state of Massachusetts, and so many of the other 48, have 
actually gone through legislation, at the state legislative 
level, to actually deal with overprescribing any opioid 
epidemic, as it existed at that time.
    We have a new opioid crisis, folks, and it is not from big 
pharma in the United States; it is from the drug cartels who 
operate pharmaceutical sites below the southern border in 
Mexico. We all know this.
    I was on the southern border a week and a half ago. It was 
my third trip to the southern border. For the record, Madam 
Chair, the President of the United States has not been. The 
Vice President of the United States was there for about three 
hours.
    But members of this committee have been there multiple 
times in the last 15 months and the thing we are told 
consistently by border agents on the ground, the people who are 
tasked with actually securing our country, is that the is the 
President's radical policies on immigration at the southern 
border have led to massive increases in trafficking fentanyl, 
trafficking methamphetamines, trafficking heroin, and 
trafficking cocaine into the United States. And that the 
fentanyl that is being trafficked into the United States is 
being laced into all pills and other narcotics by the drug 
cartels, because fentanyl is 40 percent more addictive than 
crack cocaine.
    The drug cartels are lacing this into everything that they 
traffic into the United States and that is what is leading to 
the death of American citizens, primarily by fentanyl, but then 
also by opioids, who are using illegal drugs.
    We all understand what happened with this company and what 
they were doing with the FDA, but that was 10 years ago. Why 
are we focused on an issue from 10 years ago where most of the 
legislative fixes have already occurred? I mean, are we just 
trying to get a pound of flesh for talking points? That is the 
way it seems to me, because the real issue that is happening 
right now is how we are treating trafficking of both, people 
and drugs into the United States.
    Ms. Tillipman, I am so sorry that you came here today, 
because we are wasting your time. I was told my one of my 
colleagues that you had one question this entire hearing and 
you were there prepared. But what we are talking about today 
has no impact on the United States currently.
    What does have impact on the United States currently, Mr. 
Dhillon, I have heard you give the same answer multiple times 
today, is the mere fact that the drug cartels are utilizing our 
weak and ineffective border policies to traffic more drugs into 
the United States.
    Let me give a picture to the American people how this is 
actually working. The coyotes are actually marketing to people 
in countries all over the world, not just the Northern Triangle 
countries, to all over the world that, hey, if you pay us a 
couple thousand dollars, we will traffic you into the United 
States, where, when we know that you are trying to get there, 
it is going to take you legally about three years or five years 
to get in, but if you do it our way, you can get in, in about a 
month. So, that is what is happening. They are doing this all 
over the world. The drug cartels are allowing the coyotes to 
move people across the southern border and they are getting a 
piece of the action.
    By some estimates, the drug cartels made $7 billion last 
year, if not more, allowing people to be trafficked into the 
United States because those who don't know that anything that 
moves across the southern border into the United States, the 
drug cartel is paid, whether it is legal or illegal to come 
into our country. Those are the facts.
    The immigration policy currently by Joe Biden and by 
Secretary Mayorkas, is that border agents are supposed to begin 
processing people's asylum/amnesty claims at the southern 
border and our Border Patrol is not allowed to make a 
determination on credible fear. They are only allowed to begin 
the processing of people coming into the United States and that 
they are given a day in court in front of an asylum judge. But 
the asylum judge hearings are, at a minimum, six months to 
three years, the first hearing.
    So, instead of saying people need to claim asylum or claim 
amnesty at a U.S. embassy in their home country, or if their 
country does not have a U.S. embassy, at the next closest 
embassy, the Biden administration is allowing people to travel 
two, three, four, five, sometimes six different countries, 
passing U.S. embassies and consulates, to come to our southern 
border, enter illegally, and force Border Patrol agents to 
process people, as opposed to securing the border. That is what 
is happening, America.
    Oh, and by the way, under Homeland Security, the Office of 
ORR, is they are putting people on airlines all over the United 
States and sending them everywhere.
    We are not serious. If we were serious, we would have 
Secretary Mayorkas, who is in Appropriations right now, we 
would bring him in here and ask him about the real threat.
    Chairwoman Maloney. The gentleman's time is expired.
    Mr. Donalds. Madam Chair, the real threat----
    Chairwoman Maloney. The gentleman's time is expired.
    Mr. Donalds [continuing]. to the American people, which is 
fentanyl trafficking by the drug cartels into the United 
States, and they are using radical immigration policy by Joe 
Biden to kill more Americans here.
    Chairwoman Maloney. The gentleman's time is expired.
    Mr. Donalds. Now, I will yield back.
    Chairwoman Maloney. The gentlelady from California, Ms. 
Porter, is now recognized for five minutes.
    Ms. Porter. I hope you can hear me if I don't shout.
    Mr. Sternfels, to be clear, is your position that 
manufacturer, that McKinsey, is your position that McKinsey, 
working for both, the FDA and opioid manufacturers at the same 
time, did not create a conflict of interest?
    Mr. Sternfels. That is my----
    Ms. Porter. Is that your position?
    Mr. Sternfels. That is my position, to be clear.
    Ms. Porter. OK. I appreciate your clarity.
    Let's look at what McKinsey employees told pharmaceutical 
companies. McKinsey consultants bragged to opioid-maker, Purdue 
Pharma, that their FDA work, quote, improved Purdue's ability 
to influence the regulatory environment; that is a McKinsey 
statement.
    Quote, McKinsey's FDA work improve, will improve Purdue's 
ability to influence the regulatory environment.
    McKinsey worked for Purdue at the same time it was working 
for the FDA.
    Mr. Sternfels, should McKinsey have disclosed to the FDA 
that it was helping opioid manufacturers influence drug-safety 
regulations?
    Mr. Sternfels. I will start with your direct question, 
which is we don't view our work at the FDA, at the same time, 
working with pharmaceutical companies, including opioids, as a 
conflict, because the topics were different.
    Ms. Porter. OK. I know you say that you worked on, I read 
your testimony and all of the information, you worked on broad, 
systemic issues is your claim.
    But are you suggesting that working on things like the 
design on organizational structure, staffing, resource 
allocation, building the bones of a drug safety system doesn't 
affect how those regulations actually get enforced against an 
entity like Purdue? I mean, if your work for FDA was so 
important, didn't it have some influence on what they actually 
did in the world with regard to drug manufacturers?
    Mr. Sternfels. No, it didn't, Congresswoman.
    It may be worthwhile being more specific----
    Ms. Porter. So, you charged the Government to not do 
important work?
    Mr. Sternfels. I didn't say that the work wasn't important; 
I said that it didn't actually influence their decision with 
respect to pharmaceutical companies or opioids, in particular. 
It may be worth--for the committee understanding in a bit more 
detail what actually we did with the FDA.
    This is the kind of work that McKinsey & Company performed 
for the FDA. It was implementing technology solutions so that 
we could have repeatable process. It was taking paper out of 
processes that had too much paper. It was putting in visibility 
and performance management as to where people were allocated so 
that FDA employees could actually be more productivity to help 
save taxpayer money.
    These are the kinds of aspects. We didn't design the 
processes. We didn't actually set policy. We made some of these 
core processes more efficient and effective to make the FDA 
more efficient and effective.
    Ms. Porter. Well, Mr. Sternfels, is, shouldn't the FDA have 
been allowed to make its own decision about whether or not your 
company's work for Purdue did or did not create a conflict? Why 
should you and your company be the decisionmaker here?
    Mr. Sternfels. We aren't the sole decisionmaker in this.
    Ms. Porter. Who made you conflict of interest czar for the 
United States Government?
    Mr. Sternfels. We are not the conflict of interest czar, 
Congresswoman. We follow----
    Ms. Porter. OK. So, let me ask you, did you disclose to the 
FDA your, McKinsey's work at the same time, did you disclose to 
the FDA that McKinsey was working, at the same time it was 
working for the FDA, that it was working for Purdue? Did you 
disclose that to the FDA?
    Mr. Sternfels. We made clear in multiple instances that the 
individuals involved had experience in both, pharmaceuticals 
and opioids, in particular.
    Ms. Porter. Reclaiming my time.
    Mr. Sternfels, they didn't have experience; they were the 
identical humans working for both at the same time.
    Did you tell the FDA, did you make these disclosures and 
then allow the Government to decide if there was a conflict of 
interest?
    Mr. Sternfels. When we assessed the work progress, the work 
request from the FDA, we brought professionals, our legally 
team, our dedicated government team, to understand, first, is 
there a conflict of interest?
    We verified that the work was different and, therefore----
    Ms. Porter. Reclaiming my time.
    Mr. Sternfels, that is you putting yourself as the czar of 
conflicts. Look, your scheme worked really well for McKinsey; 
McKinsey got contracts, Purdue got rich, and America got 
addicted.
    Since 2008, McKinsey earned $140 million in contracts from 
the FDA, and you did not ever disclose your work for Purdue. 
You did not disclose your conflicts of interest.
    So, my question for you is, since you didn't disclose the 
conflicts of interest, will you return to $140 million to the 
FDA?
    Mr. Sternfels. I will point you to the FDA's statement as 
recently as yesterday, where they highlight that our work was 
not related to opioids or the pharmaceutical industry 
whatsoever.
    Chairwoman Maloney. The gentlelady's time is expired.
    I now recognize the gentleman from Kentucky, Mr. Comer, he 
is recognized for five minutes.
    Mr. Comer. Thank you, Madam Chair.
    And I appreciate Representative Porter's questions about 
disclosure.
    Representative Porter, I hope you share our passion for 
wanting administration officials to have full disclosure with 
their conflicts of interest when we talk about, in January, the 
Biden family's lack of disclosures and Peter Daszak's lack of 
disclosures with his work with the WHO immediately after the 
outbreak of COVID from the Wuhan lab. So, we look forward to 
working with you on that quest for disclosures.
    Mr. Dhillon, welcome back to the committee. As you heard 
from members on our side of the aisle, we are very concerned 
about what is going on with the southern border. You can't have 
a conversation about opioid abuse without talking about what is 
going on at the southern border.
    And unlike my friends on the other side of the aisle, we 
have actually been on this committee, Republicans, to the 
border at least two times; many members, Glenn Grothman, have 
been probably seven or eight times and many other members like 
Representative Biggs and Yvette Herrell live on the border. So, 
it is a daily struggle.
    But will we be able to stem the crisis of opioids in this 
country without focusing on the southern border?
    Mr. Dhillon. No.
    Mr. Comer. Would you agree that policies that fail to 
address the situation at the southern border is exacerbating 
the opioid epidemic as cartels smuggle drugs past an 
overwhelmed Border Patrol?
    Mr. Dhillon. That is correct.
    Mr. Comer. Do you agree that Mexican trends national 
criminal organizations, or cartels, as Representative Donalds 
was talking about, manufacturer synthetic opioids in 
clandestine labs on the Mexican side of the border?
    Mr. Dhillon. They either import them from Mexico finished 
or they manufacturer them in labs. They also press them into 
pill form, also.
    Mr. Comer. That is right.
    And I was in Ohio County, a little town called Hartford, 
Kentucky, two weeks ago talking to the sheriff and they had 
just had a big crystal meth bust there, the biggest one they 
had ever had in that part of Kentucky. One hundred percent of 
that, they verified from drug agents, was manufactured in a lab 
just across the border in Mexico. They carried it right across 
the border with our lax border policies. It is just 
unbelievable.
    And when the cartels manufacturer these synthetic opioids, 
where are they obtaining the precursor chemicals from, what 
country?
    Mr. Dhillon. Largely China. India is also a country where 
they obtain those chemicals, but it is largely China.
    Mr. Comer. China. China, Madam Chairwoman.
    Do we wonder on this side of the aisle if this 
administration is compromised by China because of son of--
Hunter Biden, and now what we have learned in the last few 
weeks, Hunter Biden's uncle's dealings with China?
    Because it just seems like this country, you know, we know 
that China is contributing to the drug problem in the United 
States; fentanyl to Mexico, Mexico packs it across the border--
a hundred thousand deaths from fentanyl. We know that China 
played a leading role in COVID-19. We know that China had 
covered up a lot that went on in that Wuhan lab, but yet, this 
administration doesn't want to talk about China.
    It is odd and that is why we keep talking about Hunter 
Biden, because we wonder if this administration is compromised 
on China because of the President and the President's son and 
the President's brother's shady business dealings in China.
    Now, as Representative Donalds mentioned, we found out when 
we were on our second border trip, that the cartel, they 
smuggle both, people and drugs in their operations.
    Is that correct, Mr. Dhillon?
    Mr. Dhillon. Yes, the cartels on their side of the border 
completely control all of the passages into the United States. 
You cannot get from Mexico into the U.S. without going through 
a cartel member.
    Mr. Comer. Now, are the cartels using their human-smuggling 
operations to facilitate their drug-smuggling operations?
    Mr. Dhillon. Yes, they profit both, from human smuggling 
and they can also use them to bring drugs into the U.S.
    Mr. Comer. All right. Well, Madam Chair, I appreciate the 
concern about the opioid crisis in America. We share your 
concern about the opioid crisis in America.
    Much of what we talked about has been litigated and there 
have been many reforms made with respect to the American opioid 
producers. The problem with opioids on the southern border, and 
this administration has an open-border policy that is 
facilitating the opioid crisis in America, we need to have 
hearings with Mayorkas, with administration officials to talk 
about the Biden border crisis.
    I yield back.
    Chairwoman Maloney. The gentleman's time has expired.
    The gentleman from Vermont, Mr. Welch, is recognized for 
five minutes.
    Mr. Welch. Thank you very much, Madam Chair.
    Let me get right to it. I want to thank all the witnesses 
for being here, but I do want to direct my questions to Mr. 
Sternfels. As you know, after former President Trump nominated 
Alex Azar to serve as Secretary of Health and Human Services, 
McKinsey consultants got to work drafting a transition memo to 
share with Mister, with him.
    That memo covered six broad topics and the third one was 
the very important topic of tackling the opioid epidemic. And I 
would like to bring up that memo, if we could, so that you can 
take a look at it.
    [Slide.]
    Mr. Welch. But the draft of that section that was 
originally presented had strong language about the severity of 
the opioid crisis and it emphasized the link, that link between 
prescription opioids and the epidemic. And it read, despite 
significant attention and effort, the opioid crisis continues 
to inflict devastating consequences on the health and well-
being of people in this country. Millions of Americans are 
addicted to opioids. Approximately 95 million Americans use 
prescription painkillers in the past year; more than used 
tobacco.
    You know, I regard that as candid and complete. But the 
final version was distilled to an anodyne statement, quote, you 
are well aware of the major challenges associated with the 
opioid and associated heroin epidemic.
    So my question, Mr. Sternfels, is what happened? What 
happened to the complete and clear language, replaced by the 
anodyne, sanitized language?
    Mr. Sternfels. Thanks, Congressman.
    You know, I would start with the notion of transition memos 
for both, Democrats and Republicans taking office, has been 
something that we have often done----
    Mr. Welch. No. No. No.
    The only thing, you don't have to give me a dialog about 
the transition memos. The language was candid and complete and 
then it was anodyne.
    I mean, why?
    Mr. Sternfels. No, I appreciate where I was going is the 
memos cover the entire Department, so HHS, and if you read the 
memo entirely, it covers many topics under the remit of HHS of 
which the opioid epidemic, which I believe, and I am not exact 
on this, I think we named the epidemic six times, at least in 
the final memo, is one very important topic.
    Mr. Welch. Let me go on. Let me go on to the next question, 
because, frankly, I am not finding that an explanation.
    McKinsey did significant work for Purdue Pharma and the 
task that McKinsey had was to help that terrible Sackler family 
sell more and more drugs that got more and more people 
addicted. That was, like, the day job. At night, McKinsey did 
work for the governmental agencies that were tasked with trying 
to stem the opioid epidemic.
    So, let me ask how McKinsey can justify a day job 
facilitating the efforts of the biggest drug-dealing family in 
the history of the country and its night job was trying to help 
the Government address the problems that that drug family 
caused during the day. Just tell me how that works.
    Mr. Sternfels. Well, Congressman, I want to be very clear. 
I am not here to defend the work that we did with Purdue. I 
have noted clearly that it fell short of our standards and that 
we, and I apologized for that work, and it was part of the 
reason that we led to the accelerated settlement for the 
state's AG and are now firmly vetted in being part of the 
solution, the $575 million that we paid, standing up McKinsey 
Health Institute. So, I want to be clear on that front.
    And I also want to----
    Mr. Welch. I do appreciate that.
    Go ahead.
    Mr. Sternfels. OK. Sorry, I didn't mean to interrupt you.
    I also want to be clear that the work that we did with the 
FDA focused on improving their processes. It was agnostic of 
any pharmaceutical-specific drug, including opioids----
    Mr. Welch. Right.
    Mr. Sternfels [continuing]. and the FDA has been on 
record----
    Mr. Welch. OK.
    Mr. Sternfels [continuing]. multiple times to that effect.
    Mr. Welch. All right. Thank you.
    In fact, I only have a little time, I didn't mean to 
interrupt you, but I will just ask the professor, do you have 
any comments on this?
    Ms. Tillipman. I think there has been almost a hyper-
fixation in listening to the words that I have heard today on 
subject matter overlap. It is important to keep in mind that 
the crux of an OCI analysis is bias and, in fact, the language 
in many agency clauses and the language that are in FDA 
contracts actually ask companies to report the existence of any 
facts that may cause a reasonably prudent person to question 
the contractor's impartiality because of the appearance or 
existence of bias.
    So, by focusing exclusively on subject matter, you are only 
really taking a piece of it. All of it needs to be factored in 
and considered when you are doing an analysis of this nature.
    Mr. Welch. Thank you very much.
    I yield back and I thank the chair.
    Chairwoman Maloney. The gentleman
    [Audio malfunction.] is recognized for five minutes.
    Mr. Davis?
    Mr. Davis. Thank you, Madam Chairwoman.
    Mr. Sternfels, according to your website, McKinsey boasts 
that it is, and I am quoting, the trusted advisor and counselor 
to many of the world's most influential businesses and 
institutions, end of quote.
    Your life sciences practice, in particular, holds itself 
out, and I am quoting again, the leading consultancy for 
pharmaceutical and medical products companies, end of quote.
    In December 2020, after McKinsey entered into a $573 
million-dollar settlement with state attorneys general, 
including Attorney General Healey, for McKinsey's role in 
contributing to the opioid epidemic, your company issued an 
apology for, and I am quoting again, our work for Purdue.
    But Mr. Sternfels, McKinsey did opioid work-related for 
companies other than Purdue; isn't that right? Could I have a 
yes-or-no answer?
    Mr. Sternfels. That is correct, Congressman.
    Mr. Davis. Thank you.
    Nearly six months ago, this committee requested that 
McKinsey turn over all documents from its risk committee 
regarding its opioid and drug-consultant work. I think we 
deserve to know how McKinsey's risk processes failed at Purdue.
    It also requested client lists and work product from opioid 
distributors, like McKesson, AmerisourceBergen, and Kartner 
Health, and pharmacies like CVS and Walmart, all of whom played 
a pivotal role in this epidemic.
    You have not turned over these materials. So, Mr. 
Sternfels, can we count on you to produce these documents to 
the committee?
    Mr. Sternfels. Congressman, I want to be clear that our 
work with distributors and pharmacies did not cover opioids. I 
also want to restress our collaboration with this committee to 
turn over 375,000 pages of material, which relate to 
pharmaceutical companies beyond Purdue; some of those have 
actually related to opioids that you actually have some 
documents on.
    And if there are further questions that you are interested 
in, I would be happy to continue to work with you to answer 
those questions. We know we are not done answering your 
questions.
    Mr. Davis. OK. Is, but you can't get those to us in, say, a 
week or something that is close to that?
    Mr. Sternfels. Congressman, as I have said----
    Mr. Davis. That is----
    Mr. Sternfels [continuing]. I am happy to work with you.
    Mr. Davis. Thank you. Let me move on.
    Two weeks ago in response to the committee's staff interim 
report, McKinsey issued a statement that, and I quote, we 
understand and accept the scrutiny around our past client 
service to opioid manufacturers, end of quote.
    This statement echoed your December 2020 pledge to, quote, 
again, continue to cooperate fully with the authorities 
investigating these matters, end of quote.
    Now, Mr. Sternfels, you cannot claim to be accepting 
accountability without committing to transparency. This 
committee identified 22 McKinsey consultants who worked for 
both, the FDA and Purdue, even at the same time.
    The committee has asked what other pharma companies they 
work for. You have not told us. Congress cannot develop 
legislative reform to address these issues without fully 
understanding the extent of McKinsey's conflicts of interest.
    Mr. Sternfels, as a start, will you commit to providing the 
committee with the lists of these consultants, private sector 
clients, as requested by the committee?
    Mr. Sternfels. Congressman, I would start by agreeing with 
you on this notion of transparency and accountability; those 
are absolutely fundamental tenets for you and for us.
    We have been very clear around the 22 consultants. We don't 
hide the fact that they worked with both, the FDA and the 
pharmaceutical companies. It gets to the heart of the issue: we 
don't believe there is a conflict of interest, given there was 
no bias and there was no overlap in topic areas.
    If there are further things you would like to know----
    Mr. Davis. So, thank you, again. Now, let me reclaim my 
time before it runs out. Thank you for your answers.
    Today's hearing illustrates the dangers of allowing 
McKinsey to operate behind its code of silence. McKinsey's 
conflicts of interests have led to enormous costs, not just in 
dollars and cents, but in human lives. Without full 
transparency, there can be no accountability.
    I thank you, Madam Chairwoman, and yield back the balance 
of my time.
    Chairwoman Maloney. The gentleman yields back.
    The gentleman from Virginia, Mr. Connolly, is recognized 
for his five minutes.
    Mr. Connolly?
    [No response.]
    Chairwoman Maloney. Does he know?
    Voice. Then go to Mr. Comer for closing.
    Chairwoman Maloney. OK. Mr. Connolly?
    [No response.]
    Chairwoman Maloney. He is not listening.
    Voice. Go to Mr. Comer for----
    Chairwoman Maloney. OK. Mr. Comer, we recognize you for 
closing.
    Mr. Comer. For closing?
    Chairwoman Maloney. Yes. He is, apparently, not ready.
    Mr. Comer. Well, thank you, Madam Chair.
    And I want to, again, thank our witnesses----
    Voice. Ms. Pressley just walked in.
    Chairwoman Maloney. Excuse me, Ms. Pressley just walked in.
    Mr. Comer. OK. That is fine.
    I will yield back.
    Chairwoman Maloney. Congresswoman Pressley, you are now 
recognized.
    Voice. You are on.
    Chairwoman Maloney. Congresswoman Ayanna Pressley, you are 
now recognized and then we will go to Mr. Connolly.
    Does she hear?
    Ms. Pressley. OK. Thank you, Madam Chair----
    Chairwoman Maloney. OK.
    Ms. Pressley [continuing]. and thank you to the committee 
staff who drafted the report detailing the deceptive, callous, 
and immoral role that McKinsey has played in furthering the 
opioid epidemic.
    As Attorney General Healey mentioned, families in the 
Commonwealth of Massachusetts have been disproportionately 
impacted by this crisis. The overdose death rate in my state is 
nearly twice as high as the national average and those stolen 
lives are disproportionately people of color.
    In the Massachusetts' 7th, the district that I represent, I 
hear from community health centers and addiction recovery 
organizations that are doing all that they can to facilitate 
healing after the pain caused by McKinsey and opioid 
manufacturers.
    So, Mr. Sternfels, your apologies feel empty and insincere 
and sort of PR responses, because McKinsey was profiting off of 
the hurt and harm for years with zero remorse. In 2013, 
McKinsey presented Purdue Pharma, run by the Sackler family, 
with a strategy to, quote, turbocharge, unquote, sales of 
OxyContin.
    Ms. Feiner, as senior counsel in a lawsuit led by 
Massachusetts, was this the first time that McKinsey deployed 
the turbocharge strategy?
    Ms. Feiner. Thank you for your question.
    No. Well, McKinsey had been doing similar work for Purdue 
for a very long time, so it started early. And it also used the 
same destructive playbook with another client, Johnson & 
Johnson, for its NUCYNTA opioid. So, this was not the first 
time that McKinsey pulled out this playbook for one of its 
opioid clients.
    Ms. Pressley. Thank you.
    And, in fact, documents obtained by the committee show that 
in 2011, McKinsey consultants launched a project, as you just 
referenced, to turbocharge Johnson & Johnson's flagship opioid 
NUCYNTA. McKinsey helped to identify physicians that would 
write high numbers of opioid prescriptions. In one Johnson & 
Johnson presentation, McKinsey stated it had, quote, key 
McKinsey experts who have implemented similar efforts, unquote, 
at other pharma companies.
    Mr. Sternfels, what other companies had McKinsey worked 
with on these sales strategies outside of Johnson & Johnson?
    Mr. Sternfels. Congresswoman, first, I would apologize if 
you think that our stance is insincere. We take this stuff 
deadly seriously and it is why we are here today, and it is why 
there is nothing more important that being transparent and 
accountable with all of you.
    If a full list of the work that we do in terms of pricing 
work, revenue work, what have you, with opioid manufacturers is 
of interest, I will get you that and come back to it. I don't 
have that----
    Ms. Pressley. Thank you.
    Mr. Sternfels. I don't have the full list with me.
    Ms. Pressley. That is enough.
    OK. I will reclaim my time and look forward to that 
information if you can't provide it here in the committee 
hearing today, again, on what other companies McKinsey worked 
with on these sale strategies of turbocharge, outside of 
Johnson & Johnson. So, that is the information that I will be 
looking for.
    But, again, we know McKinsey had strategies to spread 
opioids like, quote, wildfire, and that these were strategies 
that they had perfected elsewhere. Based on the documents the 
committee has, McKinsey pushed a turbocharged opioid strategy 
at Purdue and at Johnson & Johnson; however, we need more 
documents to see what other pharmaceutical companies you worked 
with. So, I thank you in advance for your transparency on that.
    Mr. Sternfels, will you finally commit to providing the 
committee just one more time, yes or no, with all the 
information that we have requested?
    Mr. Sternfels. As I have said many times today, I am fully 
committed to continuing to work with the committee. We know 
that we are not done in answering your questions and we want to 
pursue that, quite frankly, until you feel that you have the 
answers that you need, Congresswoman.
    Ms. Pressley. Thank you.
    Like the Sackler family in Purdue Pharma, McKinsey & 
Company, you have been complicit in creating this country's 
opioid crisis and profiting off of the pain of millions of 
families. You have raked in billions of dollars every year.
    Offering an apology while avoiding responsibility is really 
worthless. What you have done is unconscionable. It is 
unacceptable. Families were robbed of loved ones by your so-
called consulting expertise and McKinsey & Company must be held 
accountable.
    And I yield back.
    Chairwoman Maloney. The gentlelady yields back.
    The gentleman from Virginia, Mr. Connolly, is recognized 
for five minutes. Thank you.
    Mr. Connolly. Thank you, Madam Chairwoman.
    And I am sorry I am in and out of this hearing. I have been 
hearing NATO meetings all morning because we have the NATO 
Parliamentary Assembly from Europe is in town and I am hosting 
them, so forgive me for being in and out.
    Ms. Feiner, I was listening to some of my colleagues. So, 
the OxyContin part of the opioid crisis began, apparently, 
south of the border; is that right?
    Ms. Feiner. Thank you for that question.
    You know, the opioid crisis began with prescription opioids 
and, largely, with Purdue's misconduct around selling 
OxyContin. And I think we can look to the----
    Mr. Connolly. But they were located south of the border, 
right, Purdue's U.S. headquarters?
    Ms. Feiner. No, they were not. They were located----
    Mr. Connolly. Oh.
    Ms. Feiner [continuing]. right in New York.
    Mr. Connolly. Oh, my lord. Oh, well, goodness. I wouldn't 
know that from their questioning.
    So, the source of OxyContin, the production of it must be 
south of the border, right?
    Ms. Feiner. Nope. Right in the United States. I believe 
that there----
    Mr. Connolly. Oh, my gosh.
    Ms. Feiner [continuing]. plants are in Rhode Island and 
North Carolina.
    Mr. Connolly. So, it is not Mexican or Central American 
doctors writing these prescriptions; it is actually good-old 
American doctors north of the border?
    Ms. Feiner. You are correct.
    Mr. Connolly. Oh my gosh. Because, you know, listening to 
some of my good friends on the other side of the aisle, I had a 
different impression and I even thought maybe Purdue Pharma, 
which really is the heart and soul of the opioid crisis in 
America that led to the hundred thousand deaths this last year 
alone, I thought it must be based in another country south of 
the border, because listening to the rhetoric of my friends.
    Well, certainly, the opioid crisis began with the 
presidency of Joe Biden, right? I mean, President Biden, we 
have to lay this squarely at his feet.
    This began about a year and a half ago; is that right?
    Ms. Feiner. That is incorrect. I think it started in the 
late 1990's.
    Mr. Connolly. Oh my gosh. All right.
    Well, I am learning something every second talking to you, 
Ms. Feiner. Thank you.
    So, let's talk a little bit about phrases like 
``turbocharge.'' What was turbocharge about? Who came up with 
that?
    Ms. Feiner. McKinsey. McKinsey actually had multiple 
meetings with Purdue in Purdue's offices, at fancy restaurants, 
and with the Sacklers. And they told them that the way to 
maintain a high volume of OxyContin sales was to turbocharge 
the sales engine to motive their salesforce, give them target 
lists for the highest prescribers in the country, and have 
their sales reps go out and visit them relentlessly, and 
incentivize the sales reps to visit them relentlessly, and to 
stick to their call plans, which McKinsey assembled. And that 
is what turbocharging was; it was to keep the sale of OxyContin 
going.
    Mr. Connolly. And by the way, just for the record, is 
McKinsey headquartered south of the border?
    Ms. Feiner. No, it is not.
    Mr. Connolly. Is it located in----
    Ms. Feiner. Right here in this country.
    Mr. Connolly. In this country, OK.
    And did that turbocharge program, then, sort of morph into 
something called ``Evolve to Excellence''?
    Ms. Feiner. It was all part of the same plan to increase 
OxyContin sales at the time that, at the same time, that 
regulators were trying to reduce opioid prescriptions in the 
United States.
    Mr. Connolly. And if we can put on the screen----
    [Slide]
    Mr. Connolly. Then something was developed, a rewards 
program called ``Wildfire.'' And I even see a picture of our 
previous President up there.
    And are you familiar with this rewards program, Ms. Feiner?
    Ms. Feiner. I am familiar with the idea that McKinsey 
looked for many ways to incent sales representatives to 
turbocharge the OxyContin sales and this was one of them.
    Mr. Connolly. And they used phrases like ``cash prizes that 
are significant and meaningful'' as part of the rewards 
program, ``enormous prestige,'' and ``celebrity status within 
the company'' if you met certain sales goals; is that correct?
    Ms. Feiner. Yes.
    Mr. Connolly. My time is going to expire, but Mr. 
Sternfels, 600,000 Americans are dead. Many people are still 
struggling with addiction.
    Do you have any regret that you want to share with the 
committee?
    Mr. Sternfels. Thank you, Congressman.
    I regret that we didn't act sooner, sir. And if I could 
play this over, I would have put the client protocols in a 
decade earlier. I would have reached settlement even faster. 
And we would have pivoted from serving the manufacturers, 
despite, you know, whatever goals there were, and I already 
apologized for that, to actually being part of the solution. 
So, if it was a regret, it would have been to act sooner, sir.
    Mr. Connolly. That is a comfort to those who lost loved 
ones during this opioid epidemic.
    I yield back.
    Chairwoman Maloney. The gentleman yields back.
    I would, before we close, like to offer the ranking member, 
Mr. Comer, an opportunity to offer his closing remarks.
    You are now recognized.
    Mr. Comer. OK. Well, thank you, Madam Chair.
    And, again, I thank our witnesses for being here today. 
And, Madam Chair, I thank you for having a history lesson for 
us today about what happened with big pharma and with McKinsey 
many years ago.
    But it is really not sincere to have a full committee 
hearing about the opioid crisis and not have any witnesses, not 
have any discussion about what is going on, on the southern 
border, because the fentanyl crisis is the opioid crisis. This 
is the drug crisis that is affected every American today, right 
now, in the present.
    You know, today, we witnessed outrage by Tlaib and Pressley 
about opioid overdose deaths in their district. Republicans 
share their outrage over opioid overdose deaths. We all have 
those in our districts.
    We heard Representative Porter express concern that 
McKinsey didn't properly disclose their conflicts of interest 
when doing contract work with the FDA.
    Republicans strongly share her concern. We want full 
disclosure of every potential conflict of interest. That is one 
role the House Oversight Committee plays; that is why we have 
requested so many hearings with respect to the origination of 
COVID-19, with respect to Hunter Biden and all the shady 
business dealings that we believe have left the Biden 
administration compromised with China, which is always at the 
root of just about every conflict with have in America now.
    We have heard many Democrats express anger with Purdue 
Pharma and McKinsey and their past wrongdoings, and Republicans 
share your anger.
    My question to Democrats is this, you have heard today, 
Republicans express our concern, outrage, and anger with the 
Biden administration and their open-border policy.
    Do you share our concern about the Biden border crisis that 
is bringing fentanyl and crystal meth and every drug imaginable 
across the border?
    If you share our outrage, join us in going to the southern 
border, listening to the Border Patrol agents. Join us when we 
request hearings and let's have a bipartisan hearing about the 
crisis on the southern border and get the appropriate Biden 
officials in here to see what they are doing about it.
    Let's not just talk about past litigation. Let's talk about 
the present and what we are going to do about it in the future. 
This is the drug issue that this committee needs to be focusing 
on: the fentanyl coming across the southern border.
    So, Madam Chair, I will conclude by, again, asking on 
behalf of all Americans, for you to hold a bipartisan hearing 
on the border crisis that is bringing in so many drugs and has 
led to a hundred thousand fentanyl deaths in the last year 
alone.
    I yield back.
    Chairwoman Maloney. The gentleman yields back.
    I thank all of my colleagues and all the panelists for your 
participation today.
    Over 500,000 Americans have died from opioid overdoses and 
that number continues to climb every day. Today's hearing 
represents a critical step in ensuring public accountability 
for those responsible for the Nation's opioid epidemic; not 
just the opioid manufacturers or their billionaire owners, but 
their hired guns, who hid behind suits and board rooms.
    We now know that Purdue and the Sacklers were relying on 
McKinsey's consultants to create the roadmap to flood America 
with addictive painkillers. McKinsey pushed the most horrific 
advice on how to push more opioids onto our hardest-hit 
communities.
    Today we learned that McKinsey reaped at least $86 million 
in revenue from consulting Purdue alone. They consulted for 
other companies on their marketing strategies and over $140 
million from the FDA.
    Mr. Sternfels, I am very disappointed that you continue to 
deny that McKinsey's consulting for the FDA and opioid 
manufacturers presented a conflict of interest and you defended 
your company's failure to disclose this information to the FDA, 
despite the overwhelming evidence of the conflicts presented 
today.
    What we need now from McKinsey is what you claimed 
repeatedly that you support, and that is transparency. We 
expect you for fully comply with the committee's document 
request by this Friday so that we can see how widely and deeply 
your firm's conflicts of interests run.
    We, many of us on this committee, introduced legislation 
today to address these conflicts of interests, and we intend to 
continue seeking legislative solutions to prevent companies 
like McKinsey from putting profits over Americans' health and 
safety.
    We look forward to working with you to get these documents 
and we look forward to working with you in passing this 
legislation.
    I would like to add, in closing, that not only are we all 
very grateful to our panelists for their remarks, and I want to 
commend my colleagues for participating very, very passionately 
today in this very important conversation.
    With that, and without objection, all members will have 
five legislative days within which to submit extraneous 
information and to submit additional written questions for the 
witnesses to the chair, which will be forwarded to the 
witnesses for their response.
    I ask our witnesses to please respond as promptly as you 
are able.
    This hearing is adjourned.
    [Whereupon, at 12:52 p.m., the committee was adjourned.]

                                 [all]