WASHINGTON - Despite its high price, the powerful cocktail of drugs now being used by HIV and AIDS patients has helped drive down the total cost of treating them, according to a new study being released Thursday.

The report, by the Rand Corporation, a think tank specializing in health, budget and military issues, said, however, that poor people are not benefiting from the new drugs because they still cannot afford them.

Dr. John Eisenberg, director of the federal Agency for Healthcare Research and Quality, which sponsored the report, called it a ``good news, bad news'' study.

The good news, he said, is that the new drugs have ``reduced the need for expensive hospital inpatient care among HIV patients as a whole. The bad news is that it didn't affect disadvantaged groups to the same degree.''

Eisenberg added that, bolstered by the Rand findings, his agency recently began a $45 million program to address the needs of lower-income Americans with AIDS or HIV, the virus that causes AIDS.

Rand's study, published in Thursday's edition of the New England Journal of Medicine, is the largest examination to date of the costs and benefits of the new drug therapies. Researchers tracked 2,864 HIV patients and used data collected from 1996, when the drugs were first introduced, through the end of 1998.

The impact of the new drugs was felt quickly. Between 1996 and mid-1997, they not only dramatically curtailed death rates, but they led to a 43 percent decline in the cost of inpatient hospital care, then the largest segment of AIDS treatment expense, the study showed.

It found that the average monthly cost to treat HIV-AIDS patients fell from $1,792 in 1996 to $1,359 in 1997 the edged up to $1,410 by 1998.

Dr. Samuel Bozzette, an infectious disease expert with the University of California at San Diego and an investigator in the study, said, ``The use of these newer drug therapies decreased the total cost of care despite their high unit cost. In other words, expensive new technologies may not be that costly from an overall societal perspective.''

But he also noted that poor patients who couldn't afford the new drugs ended up in the hospital. Expenditures on them ``were just like those in the bad old days,'' during the 1980s and early 1990s when death rates from the disease soared.

Drugs commonly used in the so-called anti-retroviral therapy are azidothymidine (AZT); lamivudine, a protease inhibitor, and nevirapine.

The study said hospital costs for HIV-AIDS patients edged up slightly toward the close of the investigation, which could mean that the disease is becoming resistant to the drugs.

In a separate study on the economics of AIDS therapies also published in the New England Journal of Medicine, other researchers found that prescribing the drug cocktail was a cost-effective use of medical resources.

Dr. Kenneth Freedberg, the lead researcher at the Massachusetts General Hospital in Boston, said the three-drug combination ``can significantly increase life expectancy, decrease AIDS-related disease incidence and quantifiably improve HIV patients' overall quality of life, all for a reasonable cost to society.''

The price, Freedberg said, ``is an extremely good value compared with other ways we spend money in all areas of medicine.''

The new drugs have helped slash death rates by more than 70 percent in the United States since the height of the epidemic in the early 1990s.

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