During the trial, Mr. Beckworth introduced a PowerPoint presentation, prepared by McKinsey for Johnson & Johnson in 2002, that raised the issue of whether the company had been sufficiently aggressive in courting patients for its fentanyl patch. In one slide, McKinsey asked, “Are we properly targeting and influencing prescription behavior in pain clinics?”
McKinsey recommended “targeting and influencing” doctors who specifically treat back pain in the elderly and those in long-term care. The consultants also advised the company to move physicians who were “stuck” in prescribing less potent opioids into prescribing stronger formulations.
McKinsey, in its statement, said its work for Johnson & Johnson “was designed to support the legal use of a patch that was then widely understood to be less susceptible to abuse.”
In court testimony, Johnson & Johnson’s corporate representative, Kimberly Deem-Eshleman, tried to distance her company from McKinsey’s advice. Twice she told the judge that these were “McKinsey’s words,” not Johnson & Johnson’s.
Mr. Beckworth, the state lawyer, asked Ms. Deem-Eshleman if her company fired McKinsey because of its recommendations. She replied no.
“Still use them today?” he asked.
“Yes, for different projects,” she replied.
Ms. Deem-Eshleman said that Johnson & Johnson’s sales representatives had called on doctors to educate them on the Duragesic patch, and that there was nothing nefarious about those visits. The company said it no longer promoted the patch.
Oklahoma’s legal case rests on the claim that the company violated a public nuisance law by harming patient health. In doing so, the state tried to contrast Johnson & Johnson’s opioid sales practices with its credo: “We believe our first responsibility is to the doctors, nurses and patients, the mothers and fathers and all others who use our products and services.”