Some medications are prepackaged, some aren't and they are obtained by pharmacies in stock bottles. You can ask the pharmacist if you can have the packages when they are available. I've found that if they are available I will be given the package. Now lets address your distrust. Pharmacists are paid well, they also have a wealth of education. Yes errors can happen but they are unlikely. The way to know if you have the right pill if you can't find it in you to trust is to check the markings in a pill identifier. all medications sold in the US have to have ID markings. I don't understand what kind of proof you took it you want. If you mean to know if you've taken them that day, use a 7 day pill box. I can guarantee you that the pharmacists salary is a tiny part of the cost of pills. Drug companies charge allot because they charge the cost of making them, and then to pay for research on it, and to pay for the frivolous huge amounts awarded in law suits, then distributors have to make money on them too, and so do pharmacies. Very few meds are made by the pharmacist and only in compounding pharmacies. The only way you would get 2 different pills is if the manufacturer of your med is changed and the pills look different, but they aren't. There is not much problem with the system, the problem here is you don't have enough experience with the american pharmacies to trust them. All prescriptions expire one year after filled. As far as contamination, pills aren't sterile and if you're worried about they are contaminated with another drug, the pill counters are clean and dry when they are used for your pills. I think you need to watch a pharmacist work for a few hours, and you may feel differently.