TRENTON, N.J. -- Not taking your medicines as prescribed can hurt your wallet as well as your health and far outweigh any savings on your pharmacy bill.

Not filling prescriptions and even skipping doses can result in serious complications and lead to ER visits and hospital stays, even premature death.

Patients not taking medicine as prescribed cost the U.S. health care system roughly $290 billion a year in extra treatment and related costs, research shows.

One study estimated those patients pay about $2,000 a year in extra out-of-pocket medical costs.

Nearly three in four Americans don't take their prescription medicine as directed. Even among those with serious chronic health conditions such as diabetes, about one in three don't.

To improve patients' health and rein in medical spending, the National Consumers League is running "Script Your Future," a three-year campaign with medical and other groups, to educate patients and get doctors and other health workers to discuss it with patients. Since it launched in the spring, more than 100,000 people have signed the league's online pledge to stick to their medication schedule.

What to do?

Some strategies for addressing these problems:

1 If you don't understand why you were prescribed a drug and the consequences of not taking it, talk with your doctor or pharmacist. If you do research on the Internet, stick to reliable websites run by government agencies, patient advocacy groups, hospitals or universities.

2 If you've been suffering side effects or worry a medicine may cause them, ask whether there's an alternative or steps to lessen side effects.

3 If money's an issue, ask whether your doctor has free samples or if there's a cheaper generic version. Also, try contacting patient assistance programs run by brand-name drug manufacturers, the industry-backed Partnership for Prescription Assistance at pparx.org or by nonprofits, including patientadvocate.org and rxhope.com. Ask your pharmacy if it participates in any discount programs.

4 If forgetfulness or confusion is the issue, try pill organizers or reminder devices. There also are smartphone applications, some free, that can send text reminders. Some cost $5 to $10 monthly. More expensive services make automated reminder calls and, if there's no response, notify emergency contacts.

Among the sites offering these items and services: epill.com, medminder.com, managemypills.com and medication-reminders.com. Many of these items also are available at Amazon.com.

Avoidance issues

Despite the consequences, patient surveys show a variety of reasons for not taking medicines as prescribed, according to Script Your Future spokeswoman Rebecca Burkholder. The most common:

--Financial problems and/or lack of health insurance.

--Complicated or confusing medication schedule.

--Forgetfulness.

--Problems with or fears of side effects.

--Belief the medicine isn't really needed. This is common with symptomless conditions such as high blood pressure.

Impact

For patients with chronic health conditions, nearly half the U.S. population, not taking medications as prescribed can bring serious consequences:

--Doctors may think a drug they prescribed for the patient didn't work and switch to another that has worse side effects or costs more.

--Deadly viruses that require daily medicine for many months can become resistant to the medicine. That can extend treatment, force the addition of more-toxic medicines or make curing the illness impossible.

--Patients who don't always take medicines for high blood pressure and cholesterol can suffer a heart attack or stroke.

--Unintended pregnancies can occur from not using birth control as directed.