Medco botched both of my refills by supplying generics that my physicians had not requested. This was shortly after I joined Medco, and these were my first refills. On my first trial order they filled both prescriptions quickly and accurately. I was told by the Medco sales force that Medco would *not* change any of the medications that I was taking-- that using Medco would be the same as going to the pharmacy of my choice. After I formally signed up, that changed. Prescription 1: a generic brand that I had used successfully for years. During the trial period, Medco managed to supply me with it with no problem. Upon refill, a different brand was substituted. I tried Brand X, and it did not work well. Called Medco and was told that they could substitute any generic at their option, and advised me to have my doctor re-order, specifying the brand name. After the re-order, Medco called me to note that they did not have my brand in stock, and was it acceptable if the order was filled in (quoting Medco) "3 or 4 days"? I said fine. Well, I've just received the prescription, 15 days after the re-order. Prescription 2: a well-known brand medication manufactured by Bristol-Meyers Squibb. Instead, I received a generic manufactured by Winthrop. Called Medco: "Your doctor ordered the generic. We received a fax.". Called my doctor, who searched his records. "No fax was sent to Medco and the doctor would never switch you to a generic without discussing it with you first." Back to Medco: they had contacted the doctor by phone and he had prescribed the brand name. Medco had sent me the generic because it is a "close substitute". Medco also told me, in a separate conversation, that they might "have difficulty" obtaining the brand name from Bristol-Myers Squibb. Funny, Medco had located Bristol-Myers Squibb just fine during my trial period. The brand name drug is on order. Summary: Despite the promise of its sales force that Medco would keep me on the same meds that my pharmacy had supplied, it did not do this in the case of both drugs that I take. In one case, the substitute drug did not meet my needs, and it took an additional 15 days for me to receive the drug after Medco had received the re-order. Medco also substituted without authorization a generic for the brand name drug ordered by my physician. The re-order is being filled. While Medco indeed costs less than a bricks and mortar pharmacy, the service is not good. Fixes: --Have your physician write your prescription specifying: 1)the name of the medication, 2)the name of the manufacturer you want and 3) the letters DAW (dispense as written). This will prevent substitutions. --Have your physician write you an extra prescription that you can take to a pharmacy, in case Medco fails to fill your prescription on time. --Write the Federal Trade Commission and your state's 1)Department of Consumer Affairs and 2)Attorney General with your complaints. drug that my physician had ordered.