'McKinsey' Drug Report Revisited by Horsemen

A 1991 report on drug testing in the United States was revisited March 19.

As McKinsey & Company prepares for The Jockey Club a broad report on Thoroughbred racing, a horsemen’s group has reviewed a medication study the company authored 20 years ago.

“The McKinsey Report,” as it’s called in the racing industry, was released May 11, 1991. It suggested ways the industry could improve equine drug-testing and save money in the process.

The National Horsemen’s Benevolent and Protective Association revisited the report March 19 during its winter convention in Hot Springs, Ark. Officials said recommendations in the McKinsey Report were largely unheeded until the last year or so.

Florida HBPA executive director Kent Stirling, who chairs the National HBPA Medication Committee, said he heard about the report in the late 1990s and requested a copy from The Jockey Club.

“I had to clean off the dust,” Stirling said. “If we had done what they said we should have done, we may not be having the problems we have today.”

The National HBPA, a strong proponent of setting threshold testing levels for therapeutic medications used for racing, covered several of the key recommendations in the McKinsey Report: setting threshold levels for any drugs permitted on race day; conducting research to set threshold levels for trace amounts of the medications; and devising a consistent penalty structure that would include the trainer, veterinarian, and owner.

“There were a lot of great ideas in there,” Stirling said.

The national Racing Medication and Testing Consortium a few years ago began implementing some of the McKinsey Report recommendations. Dr. Steven Barker, state chemist for the Louisiana State Racing Commission, said the report made strong recommendations but it’s now outdated in some respects.

Barker said the report considered testing methods that are hardly used today, and didn’t predict major changes in technology that has laboratories detecting parts per trillion in a blood or urine sample.

State-of-the-art testing equipment has led to detection of trace amounts of therapeutic drugs commonly used for training and racing. Some regulators call them “positives,” but others don’t pursue action.

“It makes it look like there’s a lot more illegal drug use going on,” Barker said. “In Pennsylvania, ultra-trace amounts were reported to the racing commission. There is no filter between the laboratory and the racing commission’s action.

“Positives continue to be called daily for therapeutic drugs. Threshold levels for the most part have been accomplished, but now they’re changing the (limits of detection). The only thing I would say in that regard is, ‘Make up your mind'.”

Dr. Rich Harden, equine medical director for the Virginia Racing Commission, called the McKinsey Report an “excellent document” but also noted it must be updated to reflect current drug-testing technology. He said Virginia regulators look for drugs administered after a horse is entered for a race, not while it’s in training.

Also, stewards in Virginia make the call on whether to call a positive after a test, Harden said. Recommendations may not be carried forward if the positive is for therapeutic drugs.

“I would encourage (the industry) to have a way so an uninterested party can make recommendations to the stewards,” Harden said.

Dr. Don Shields, a Southern California equine practitioner, said positive tests for legal therapeutic drugs are by far the most common. In California, the bulk of them, he said, result from mistakes in administration; in 2009-10 there were 19 positive calls for Class 1, 2, and 3 drugs—the strongest—and 95 for Class 4 substances, which are largely therapeutic.

Shields discussed the latest national recommendation that the testing threshold for phenylbutazone, a commonly used non-steroidal anti-inflammatory drug, be lowered from 5 micrograms per milliliter of plasma or serum to 2. Shields said that in California, more than 80% of racehorses already fall under 2 micrograms per milliliter.

Shields said phenylbutazone at a certain level can impact a pre-race exam, and that regulatory veterinarians do need transparency to aid them in examinations. But he said the lower threshold level for the drug could lead to more positives and bad public relations for the racing industry.

“Are our PR problems self-inflicted?” Shields said. “Better drug testing has not improved public opinion. We need to do more, but we need to do something different.”

Shields suggested “targeted policing” such as pre-race surveillance. He said the cost could be offset by reductions in the amount spent on drug testing.

“What we choose to do is everything, and we must choose well,” Shields said.

Dr. Thomas Tobin, the National HBPA medication adviser from the University of Kentucky Department of Veterinary Science, said the McKinsey Report drew a distinction between therapeutic drugs used in training and racing. Now, he said, training and racing are being “lumped together.”

As for phenylbutazone, Tobin said the threshold level was 2 micrograms per milliliter in 1980, 5 micrograms per milliliter in 1985, and 2 micrograms per milliliter in 2010. “Is 2 an actual 24-hour threshold?” Tobin said. “I remain unconvinced.”

Stirling said The Jockey Club was invited to send a representative to participate in the March 19 panel but declined. He said Jockey Club executive vice president and executive director Matt Iuliano sent a letter saying the RMTC provides the industry framework for drug-testing policies, and that the McKinsey Report “may have been ahead of its time.”