| IVOD_ID |
160176 |
| IVOD_URL |
https://ivod.ly.gov.tw/Play/Clip/1M/160176 |
| 日期 |
2025-04-16 |
| 會議資料.會議代碼 |
委員會-11-3-26-6 |
| 會議資料.會議代碼:str |
第11屆第3會期社會福利及衛生環境委員會第6次全體委員會議 |
| 會議資料.屆 |
11 |
| 會議資料.會期 |
3 |
| 會議資料.會次 |
6 |
| 會議資料.種類 |
委員會 |
| 會議資料.委員會代碼[0] |
26 |
| 會議資料.委員會代碼:str[0] |
社會福利及衛生環境委員會 |
| 會議資料.標題 |
第11屆第3會期社會福利及衛生環境委員會第6次全體委員會議 |
| 影片種類 |
Clip |
| 開始時間 |
2025-04-16T09:24:04+08:00 |
| 結束時間 |
2025-04-16T09:37:35+08:00 |
| 影片長度 |
00:13:31 |
| 支援功能[0] |
ai-transcript |
| video_url |
https://ivod-lyvod.cdn.hinet.net/vod_1/_definst_/mp4:1MClips/f9d2e74df98279df716d2b3a929529f3d598beef862d51bb9b98284df90a891abd9c4a74a059f27d5ea18f28b6918d91.mp4/playlist.m3u8 |
| 委員名稱 |
陳昭姿 |
| 委員發言時間 |
09:24:04 - 09:37:35 |
| 會議時間 |
2025-04-16T09:00:00+08:00 |
| 會議名稱 |
立法院第11屆第3會期社會福利及衛生環境委員會第6次全體委員會議（事由：邀請衛生福利部部長就「面對國際經貿情勢瞬變，我國如何因應並確保藥品、醫療器材等各面向供應正常，保障國人權益。」進行專題報告，並備質詢。
【4月16日及17日二天一次會】） |
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謝謝主席,麻煩請邱部長兩位署長,江署長跟石署長麻煩帶一份今天的書面資料,一份就放桌上因為我對資料有點,今天看到有點問題兩位署長就江署長、石署長 |
| transcript.whisperx[1].start |
31.335 |
| transcript.whisperx[1].end |
51.131 |
| transcript.whisperx[1].text |
對於藥品穩定供應的相關機制裡面再請看第二頁對於必要藥品的清單是很重要的那不好意思我可不可以麻煩那個江署長您可不可以念一下這一段因為這一段是您的你們署寫的來制定必要藥品清單請問是書面報告還是口頭報告你讀一下因為才三行字來麻煩快點 |
| transcript.whisperx[2].start |
52.873 |
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65.039 |
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對,請署長讀,署長來第二頁,第二頁,制定必要清單,滾動式來,您自己再稍微了解一下你時間稍微考起來,時間稍微考起來,你找不到自己的資料,拜託拜託時間給你考起來,滾動制定必要藥品 |
| transcript.whisperx[3].start |
70.382 |
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86.586 |
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清單 滾動式檢討藥品清單以強化藥商預先通報的責任及必要藥品供應不足之與之實之因應之道好 請暫停 必要清單你知道有幾項嗎 必要藥品你知道大概有幾項嗎 誰決定的我們現在是訂了584項然後是誰決定的 |
| transcript.whisperx[4].start |
90.757 |
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是在我們這邊的盤點之後最後的確定就是誰決定 誰去做這個必要清單的決定我們在食藥署這邊盤點確定下來的不是 他一定有認定啊必要有一個認定過程啊這是第一個第二個 你有這個名單你的目的是為了強化廠商通報嗎對 |
| transcript.whisperx[5].start |
108.772 |
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135.538 |
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它不是為了強化廠商 因為我們最主要是要穩定嘛所以如果是一個寡占 我們的所謂的你說得好 署長所以它不是為了強化它通報機制廠商啊責任不在廠商啊你中央要有一個知道說我訂了必要清單你現在講不出必要清單是誰訂的 OK啦沒有就是說 再去了解必要清單訂下來以後 你要知道我要穩定供應不是廠商因為它不需要知道別人怎麼供應法 |
| transcript.whisperx[6].start |
136.118 |
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160.694 |
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你同意嗎?你要有這個中央的監控我稍微提一下我這邊是我們針對這個必要的藥品清單確立之後他就會有相對的供應的廠商那我們會有一個登錄的系統底下能夠照他們藥庫裡面來要求因為你管的是幾百項你竟然訂了幾百項把我嚇到了好幾百項必要那我再問你一件事你知道健保署有他自己的另外一套清單 |
| transcript.whisperx[7].start |
162.317 |
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181.292 |
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你知道嗎 我現在知道 你知道嗎這個我沒有很確定你們兩個從來沒有牽手 該我承受一下食藥署跟這個下游的就從來沒有牽手過好 那個石署長就麻煩您念一下第五頁黑是你的 所以我請你念來 第四項第五頁那個黑是確保藥品供應維持合理請你念一下那一段 快一點 謝謝 |
| transcript.whisperx[8].start |
182.733 |
| transcript.whisperx[8].end |
206.801 |
| transcript.whisperx[8].text |
確保藥品供應維持合理要價冒號經主管機關公告之必要藥品並符合同分組內有國內製造品項並符合同分組內有國內製造品項抗維生物質既不在此限這個重複了抱歉即從分組分類未遇及同分組分類 |
| transcript.whisperx[9].start |
208.903 |
| transcript.whisperx[9].end |
210.606 |
| transcript.whisperx[9].text |
這個好像有三個品項的條件當年度要駕步與調整 |
| transcript.whisperx[10].start |
216.38 |
| transcript.whisperx[10].end |
238.525 |
| transcript.whisperx[10].text |
以確保藥品供貨穩定 平衡藥價調整與健保支出再為我今天要多一點點時間你看都是他們資料有問題第一個署長你讀不懂嘛對不對讀不通讀不通因為沒有整理文字沒有確定就把它交上來嘛那對我們來說這很重要然後請問你健保署有所謂的必要藥品嗎 |
| transcript.whisperx[11].start |
239.775 |
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267.263 |
| transcript.whisperx[11].text |
我們是參考這個FDA所訂的那個必要藥品清單請等一下健保署沒有必要藥品這四個字育文組長對不對沒有我們這個這次修法才有你的名稱是什麼你的名稱是什麼你不叫必要藥品因為你為了當年為了怕跟食藥署混在一起叫什麼特什麼他只要回答名字就好了我時間也很寶貴叫特殊叫我們特殊品 |
| transcript.whisperx[12].start |
267.703 |
| transcript.whisperx[12].end |
296.639 |
| transcript.whisperx[12].text |
早就改了嗎我們叫特殊品對你們沒有必要藥品清單時書長你們沒有必要而且是2016年之前就改了現在我們在修法就是修這個就是藥價調整辦法修進來的這是新的草案條文時書長你剛剛第一個就是文字儀化整理大家看不懂而且我覺得三項以內應該就是不予調整要予調整這個讀起來都很奇怪還有兩位署長再麻煩你看部長就在旁邊了解你們兩個的必要藥品括號你叫特殊藥品你叫必要品 |
| transcript.whisperx[13].start |
297.539 |
| transcript.whisperx[13].end |
318.871 |
| transcript.whisperx[13].text |
你有幾項 實屬者你有幾項必要 那個特殊品項有幾項我們現在以這個新的修法的剛剛這個條文的話是跟食藥署是一致的我們是用必要藥品一樣的名稱現在我們一直在處理啊你是叫特殊品項 而且你還裡面分兩類嘛沒有替代性跟有替代性的嘛然後你現在有幾項 |
| transcript.whisperx[14].start |
320.154 |
| transcript.whisperx[14].end |
340.951 |
| transcript.whisperx[14].text |
你還沒修法都不要講我們現在有800多項啦好 你看 你兩個有幣過嗎?你的800跟你的500 你們有幣過嗎?好 關關這個問題要解決這個什麼關稅的那個牌效你們的必要清單就都沒有了我今天在資訊廣告還沒有用那個FDA的必要藥品清單都在我們這個裡面 |
| transcript.whisperx[15].start |
343.735 |
| transcript.whisperx[15].end |
358.306 |
| transcript.whisperx[15].text |
我們都包含在裡頭了好像不是喔 署長我對他置身三十年好像不是這樣 都是有專家認定的部長 你看 我先問你 不然兩位先回座好了這個署長 施署長 我等一下其實本來要告訴你你說可以調整 因為更不夠 必須調整但是你知道調整的過程要多久嗎 |
| transcript.whisperx[16].start |
365.771 |
| transcript.whisperx[16].end |
374.756 |
| transcript.whisperx[16].text |
還有什麼步驟嗎 你知道嗎我們當然調整的過程還是需要跟廠商去議價那也要經過共同議會議通過不是不是 你要經過專家會議他經過共同議會議然後你要認定調價你允許 因為這太特別了這一次的調價你平常不是這麼做的你平常就算他們提出成本分析你都要去判斷說有沒有類似藥品其實成分不一樣有沒有類似藥品可以用有沒有 那個很判斷 |
| transcript.whisperx[17].start |
394.046 |
| transcript.whisperx[17].end |
419.391 |
| transcript.whisperx[17].text |
很主觀的東西所以第一個你還說這個是必要品你先讓他申請你要不要認定認定可不可以調之後第二個才我怎麼調法或不調然後你的屬下堅持要分開會議處理要兩次會議處理我曾經提案在你還沒有開除我之前我曾經提案說兩件事一起處理不要等時間因為既然是重要的藥品缺藥過去也有缺藥不是現在才缺藥啊 |
| transcript.whisperx[18].start |
420.171 |
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445.187 |
| transcript.whisperx[18].text |
但是你的步驟是這樣 你知道總共多少嗎跟委員報告 在這次書役的時候我們就採取了快速的處理 那個沒有問題我們這一次已經有經驗了你的專家群會再去認定啊所以你這次報告寫的東西 不對嘛因為報告寫裡面的必要清單我們就會給予這個 如果說因為關稅等等要這樣改變 我們就去處理但是你的專家可不是這樣講因為你的上情從來不下達專家還是用他原來那一套在跑好嗎 |
| transcript.whisperx[19].start |
448.435 |
| transcript.whisperx[19].end |
472.155 |
| transcript.whisperx[19].text |
不過這個現在我們就很清楚了我們跟這次的修正辦法就是跟食藥署同步我們採用一樣的標準他認定的過程喔而且他認定還分兩次會議對不對 藝文組長沒錯吧結果我這次先認定你是不是屬於我們認為我們需要的不是你講的必要名單喔不是說放在必要清單特殊品項就直接調不是喔你就先說好 |
| transcript.whisperx[20].start |
473.436 |
| transcript.whisperx[20].end |
496.655 |
| transcript.whisperx[20].text |
我先認定一次好下次會議也不知道一次個月還兩個月後好我再來認定好可能還是不調喔可能還是不調喔因為調價是兩件事認定跟調價兩件事情你們現在作業是這樣做的對當然是要有必要才調當然是這樣啊這個藥品一定要分開嗎沒有可替代的我們才調有替代的我們當然用替代還是要為健保省錢啊保管啊都在清單裡面啊那你的清單是假的 |
| transcript.whisperx[21].start |
499.997 |
| transcript.whisperx[21].end |
514.409 |
| transcript.whisperx[21].text |
清單有兩種處理在這個必要藥品 清單剛剛我提到的是在調整藥價的時候它是稀缺品項 我們不予調價另外一個是調整 要調高調高那個是根據34條 35條來 要不夠剛剛回答的是那個特殊品項是800多必要藥品我們現在是跟FDA同步了所以我們才在修這個辦法的目的就是在這裡讓它同步 |
| transcript.whisperx[22].start |
527.628 |
| transcript.whisperx[22].end |
541.742 |
| transcript.whisperx[22].text |
是他跟你同步還是你跟他同步你是要付錢的喔他的必要品可能不付錢喔你這個兩位署長你們要搞清楚你一個是負責發證讓這個藥品可以進來必要藥品我們一定會納入給付必要藥品一定納入給付 |
| transcript.whisperx[23].start |
542.813 |
| transcript.whisperx[23].end |
562.335 |
| transcript.whisperx[23].text |
你過去不是這樣的原則的喔那我再跟你講一次你現在沒有必要藥品從我在這裡就是用這個原則在處理這件事沒有沒有你一直上情不下達你沒有進去開會啊你沒有進去開專家會議啊我在那邊30年了你沒有進去開會啊一直都不是這樣所以我今天真的是為了這個報告我今天的質詢稿都不能講了 |
| transcript.whisperx[24].start |
563.656 |
| transcript.whisperx[24].end |
578.471 |
| transcript.whisperx[24].text |
我今天看你們第一個你們兩個署很重要一個上游是許可證進來然後大家等著要健保給付你這個兩端大家從來不牽手各自做各自的你看大家也聽到到目前為止因為你說要準備修法 |
| transcript.whisperx[25].start |
578.871 |
| transcript.whisperx[25].end |
596.3 |
| transcript.whisperx[25].text |
可是到目前為止你的必要清單跟你的以前叫必要清單後來叫特殊因為你們怕confuse在一起你們還擔心混淆在一起所以你們特別切割特別去切割然後又為了怕這個跟什麼WHO的必要品清單混在一起這件事一塌糊塗 |
| transcript.whisperx[26].start |
597.501 |
| transcript.whisperx[26].end |
602.286 |
| transcript.whisperx[26].text |
然後處理方式都不一樣啊那現在說你要跟他看齊欸這麼快嗎幾百項要跟他看齊但是看齊了以後等到缺藥那你也不去處理要價啊那個處理要價另外一套規則你那幾十個專家委員從來沒有聽過你這套規則他們處理的方法幾十年都一樣還是用他們主觀的感覺去決定我要不要給你調降啊就算他給你成本分析你還是不給他動啊 |
| transcript.whisperx[27].start |
622.062 |
| transcript.whisperx[27].end |
628.151 |
| transcript.whisperx[27].text |
我們今年在要價調整的時候就已經調整了200項都是調整要價油啊 |
| transcript.whisperx[28].start |
629.178 |
| transcript.whisperx[28].end |
658.087 |
| transcript.whisperx[28].text |
有這個機制啊那不是必要藥品反正我今天因為我是針對你們的題目你們的書面資料我也讓部長知道部長當然不會知道這麼仔細第一個兩個各自有他的自己清單從來幾十年來從來不簽手的各自做各自的那健保署為了付錢有他自己的遊戲規則而且就是盡量時間很慢幾個月會通過一半以上都不給予調整 |
| transcript.whisperx[29].start |
659.387 |
| transcript.whisperx[29].end |
680.1 |
| transcript.whisperx[29].text |
調生價錢或是調尤其是調生你們是非常非常小氣的完全就是等等等等然後到最後導致生理食鹽水嘛剩一家嘛對不對江署長生理食鹽水會搞到這樣就是因為他後來剩一家你不知道你的監測機制出問題嘛剩一家你都不注意你叫要他通報你一直盯他可是其他人沒有辦法再備著支援備用所以你這邊斷了 |
| transcript.whisperx[30].start |
681.061 |
| transcript.whisperx[30].end |
689.729 |
| transcript.whisperx[30].text |
然後斷了以後健保署才不知道說我今天沒辦法談要價差你付25他賣18其他人撐不住就這一家長在撐用18塊撐到他也撐不住品質了出問題了然後林次長去國外買買51塊不准有要價差而且去年花了3、4億今年又變了11億11億等著犯錯穩定生理食鹽水穩定專案經濟有責任 |
| transcript.whisperx[31].start |
706.757 |
| transcript.whisperx[31].end |
717.44 |
| transcript.whisperx[31].text |
謝謝委員那我們其實特別跟委員報告我們3月24號這個供應的國內的廠已經恢復他的產線所以我們3月24號的監督機制就是怎麼去訪問我剛剛的重點說你哪必要清單都不一樣但是你們只記得以強化我特別讓你們以強化廠商的通報責任在廠商嘛你要通報廠商沒有必要負責我總共台灣有幾家在供應嘛所以這個供應的問題中央公司監測是由我們官方要來處理嘛不能當一家獨大然後那一家品質出問題 |
| transcript.whisperx[32].start |
735.726 |
| transcript.whisperx[32].end |
752.014 |
| transcript.whisperx[32].text |
可能就是藥價差搞成沒有辦法沒有辦法用錢去生產有品質的所以全國大斷藥啊基本用就沒有了健保署是很後來的事情去調整的事情我今天你看以後把資料弄清楚然後把名詞弄清楚 |
| transcript.whisperx[33].start |
752.714 |
| transcript.whisperx[33].end |
775.275 |
| transcript.whisperx[33].text |
食藥署迄今沒有必要藥品的清單食藥署的必要清單是用自己管理的不是為了讓廠商通報廠商通報只是其中他們要做的一件工作你要從中央控制不要再讓生理食鹽水這麼它還不算必要藥品我認為它是基本的用藥你沒有生理食鹽水更不能開業好嗎台灣的醫療業都不要營業了它是基本的用藥還不是必要必不必要的問題 |
| transcript.whisperx[34].start |
776.396 |
| transcript.whisperx[34].end |
777.137 |
| transcript.whisperx[34].text |
非常謝謝我們委員做專業的一個建議要簽手 多簽手要簽手 公開簽手真的簽手 |
| transcript.whisperx[35].start |
792.572 |
| transcript.whisperx[35].end |
804.579 |
| transcript.whisperx[35].text |
特別年紀相當 因為你上游發許可證 下游健保給付 大家要多合作我們共同為人民的健康 藥品的同意來一起努力非常謝謝委員長的指教 |