They mean that during the approval process someone showed that the drug could last this long without degradation. If the drug is manufactured in 1990 and in 1992 it was tested and it contained enough of the drug, the U.S. FDA will allow the manufacturer to claim a two year shelf life. It does not mean that anyone ever showed any drug degradation after two years.
That test is rarely done. When it is performed, tests regularly show shelf lives of four years beyond the advertised life. What's more, even if the drug decays, that is not evidence that it has become harmful. The two doctors in this article (Cantrell and Clancy) have never heard or read “of anyone being harmed by any expired drugs”.
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