When I use a word . . . Drug stock-outs

A deficiency in the availability of a pharmaceutical product is usually known as a shortage. However, the term “stock-out” has also been used to describe a deficiency that occurs locally. It is sometimes hard to determine when a stock-out becomes a shortage, and that may be why stock-outs have been less well studied than shortages. In addition, because they are local, stock-outs may be thought by some to be less important than shortages. However, the causes of stock-outs may be different from the causes of shortages and they are as important to those who are affected as shortages are, even though there are fewer of them. Two years ago colleagues and I published two papers detailing various aspects of drug shortages.12 We covered definitions of the relevant terms, causes of shortages, the harms they can cause, and potential solutions. To do this, we looked for published definitions, of which we found 79. We also searched PubMed, Medline, and EMBASE to the end of 2022, initially using the term “shortage*.” However, this resulted in many thousands of hits, and we therefore restricted our search to the use of the term in titles of papers, of which we found about 6700. My most recent search has extended this to nearly 8000. In principle “shortage” is not hard to define. The Oxford English Dictionary ( OED ) does it succinctly: “Deficiency in quantity; the amount by which a sum of money, a supply of goods, or the like, is deficient.”3 However, when it comes to defining a drug shortage, problems arise. First there is the question of extent, and specifically …