(Reuters) - McKinsey & Co will pay $45 million to settle an investigation by Nevada of the big consulting firm’s role in fueling the U.S. opioid epidemic. Nevada had been the lone holdout among U.S. states investigating McKinsey’s conduct, and Monday’s settlement boosts the firm’s payout for opioid settlements to about $641 million. McKinsey had in early February reached a $573 million settlement with 47 U.S. states, the District of Columbia and five U.S. territories, plus $23 million of settlements with Washington state and West Virginia. A McKinsey spokesman said the firm did not admit wrongdoing or liability, believes its past work was lawful and has denied contrary allegations. The settlements came after lawsuits showed how McKinsey advised drug manufacturers, including Purdue Pharma, which makes OxyContin, on how to market opioids, including by targeting high-volume prescribers. Nevada Attorney General Aaron Ford said his state settled separately because Nevada has been particularly hard hit by the opioid epidemic and has seen a resurgence of opioid-related deaths during the COVID-19 pandemic. “McKinsey’s willingness to settle with Nevada, along with sister states, will help focus our energy on addressing the problem,” Ford said in a statement. The U.S. government has said opioids contributed to the deaths of more than 450,000 people from 1999 to 2018. On March 10, McKinsey replaced Kevin Sneader as global managing partner, elevating Bob Sternfels to that role. In announcing the earlier opioid settlements, Sneader had said: “We deeply regret that we did not adequately acknowledge the tragic consequences of the epidemic... We hope to be part of the solution to the opioid crisis in the U.S.” Purdue, which is in bankruptcy, agreed last October to plead guilty to criminal charges over its marketing of OxyContin. Members of the Sackler family who own Purdue have offered $4.275 billion to help settle about 3,000 lawsuits over the company’s conduct.