Studies say Americans who don\'t take prescribed medications waste billions annually because the missed doses lead to emergency room visits and hospitalizations. A study by Express Scripts, an independent prescription- filling company, says the problem costs $258 billion a year, while a second study by CVS Caremark, Harvard University and Brigham and Women\'s Hospital put the figure at $290 billion, USA Today reported Friday. Both studies analyzed data from their own customers, insurance payouts, previous research and surveys. \"Drugs don\'t work if you don\'t take them, and people often don\'t take them the way they\'re supposed to,\" Bob Nease, chief scientist at Express Scripts, said. The CVS study estimated that if 35 percent of people in a group of 100,000 failed to take their medications as directed, there would be 16 heart attacks, five strokes and seven deaths, Troyen Brennan, chief medical officer for CVS Caremark, said. People miss medication doses because they neglect to refill their prescriptions, forget to take them, decide they don\'t need them or feel they can\'t afford them, Edith Rosato of the National Association of Chain Drug Stores said.