| IVOD_ID |
160195 |
| IVOD_URL |
https://ivod.ly.gov.tw/Play/Clip/1M/160195 |
| 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 |
2025-04-16T10:09:16+08:00 |
| 結束時間 |
2025-04-16T10:30:55+08:00 |
| 影片長度 |
00:21:39 |
| 支援功能[0] |
ai-transcript |
| video_url |
https://ivod-lyvod.cdn.hinet.net/vod_1/_definst_/mp4:1MClips/f9d2e74df98279dfe98972861bb53f42d598beef862d51bbd146475ae9ed72cd0c1acf7fe19f66a45ea18f28b6918d91.mp4/playlist.m3u8 |
| 委員名稱 |
林淑芬 |
| 委員發言時間 |
10:09:16 - 10:30:55 |
| 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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| transcript.whisperx[0].start |
0.066 |
| transcript.whisperx[0].end |
8.568 |
| transcript.whisperx[0].text |
我們就請邱部長邱部長來 |
| transcript.whisperx[1].start |
26.144 |
| transcript.whisperx[1].end |
29.257 |
| transcript.whisperx[1].text |
委員好 部長你說到現在為止沒有缺藥漲價之餘這句話說得很快 |
| transcript.whisperx[2].start |
31.874 |
| transcript.whisperx[2].end |
57.853 |
| transcript.whisperx[2].text |
我聽到覺得膽戰心驚 最好是如此你今天的書面報告裡面啊直接就講了你們的因應作為對穩定這個藥品的供應的相關機制因應作為第一 建立藥品短缺通報處理機制第二個 制定必要藥品的清單第三 鼓勵業者增加原料來源和儲備建立原料要加速審查機制最後還主動監控國內外藥品的供應我現在要問你第三點 第四點 |
| transcript.whisperx[3].start |
59.595 |
| transcript.whisperx[3].end |
83.356 |
| transcript.whisperx[3].text |
叫大家囤更多原料這些原料都沒有效期嗎這一批原料用完了以後如果國際間大家都知道中國和印度如果為了因應美國的這一波關稅的這個調整那他們在原料供應上也漲價呢或者是沒有機遇漲價自然的供需失衡因為大家都要搶 你要搶大部分人也要搶原料 |
| transcript.whisperx[4].start |
86.138 |
| transcript.whisperx[4].end |
107.828 |
| transcript.whisperx[4].text |
在這個供需失衡大量之間瞬間的需求大量增加大家都知道價格一定上漲光是這樣子價格就會上漲你還敢說現在沒有當然現在沒有啊但是未來就有啊所以你建立原料要的加速審查機制加速審查跟價格上漲供需失衡這樣的問題有相關嗎你講了這樣子就可以穩定了嗎 |
| transcript.whisperx[5].start |
112.63 |
| transcript.whisperx[5].end |
139.723 |
| transcript.whisperx[5].text |
價格上漲以後藥品的價格上漲當然會排擠到整個健保預算所以這一些醫生在擔心的是排擠到他們的點值會下降他們醫院擔心的是藥品的成本上漲這個通通都是一環扣一環非常嚴重的事你制定藥品清單我就不好意思講了以前生理食鹽水之亂生理食鹽水之亂它不是必要的藥品 |
| transcript.whisperx[6].start |
141.792 |
| transcript.whisperx[6].end |
157.51 |
| transcript.whisperx[6].text |
你說你們要這個有短缺通報機制然後監控國內外藥品的供應哪一次你們沒有監控啊 我不好意思說你們的鮮血水之亂還不是必要藥品 你就沒得了 有監控就沒得了啊 |
| transcript.whisperx[7].start |
158.447 |
| transcript.whisperx[7].end |
184.01 |
| transcript.whisperx[7].text |
哪一次沒有監控完藥品還是短缺啦休暑它的藥品組的監控能力在哪裡連國內藥品都沒有能力監控了現在要監控國外的藥品我們的能力你真的對自己這麼百分之百的自負嗎更不要講光是食鹽水之亂我就提出了一個清單叫你們盤點 |
| transcript.whisperx[8].start |
185.492 |
| transcript.whisperx[8].end |
194.694 |
| transcript.whisperx[8].text |
你們盤點了多久啊我說國內藥品 市占不均容易發生原料短缺的藥品名單如果沒有我叫你們去盤點 你們沒有盤點我叫你們盤點 講過幾遍 你清單搞不出來問幾遍啦 搞不出來所以食藥署跟衛福部一直被人家講管理食品也不行 藥品也不行 |
| transcript.whisperx[9].start |
213.838 |
| transcript.whisperx[9].end |
221.382 |
| transcript.whisperx[9].text |
現在我更高興的是 保證 你第一次跟他說有恃無恐 跟他說我都喘得好好的 沒事情沒問題今天你說了這幾項 就答非所問了常常出問題 不是沒問題我...我...好啦 我現在從頭問起好了啦 |
| transcript.whisperx[10].start |
235.809 |
| transcript.whisperx[10].end |
242.895 |
| transcript.whisperx[10].text |
現在我問你們說光是盤點美國製造的美國當地製造進來的藥品或醫材清單品項數量光是這個喔多少喔 我不懂怎麼說只要你們自己補你今天報告的跟食藥署提供的跟健保署提供的就倒不會罵啦 |
| transcript.whisperx[11].start |
260.916 |
| transcript.whisperx[11].end |
273.364 |
| transcript.whisperx[11].text |
倒不會吧跟他一個數量的盤點你的數據提供出來都不會正確了那我跟他講缺藥的問題缺藥的問題在關稅這個政策以前早就存在了缺藥的問題講多久啦沒有美國關稅這個題目我們國內問題就很嚴重了這又不是現在你還說現在都沒問題 |
| transcript.whisperx[12].start |
290.578 |
| transcript.whisperx[12].end |
313.425 |
| transcript.whisperx[12].text |
沒有美國關稅這一題 現在問題就很嚴重現在是美國關稅政策的之下會不會更嚴重所以醫改會在講說我們高度仰賴進口仰賴美國供應的 特別他指出癌症用藥疫苗聽得清楚 疫苗 |
| transcript.whisperx[13].start |
315.168 |
| transcript.whisperx[13].end |
336.16 |
| transcript.whisperx[13].text |
高階醫材 小兒醫材 抗生素等美國供應商常連扮演著關鍵性的角色所以呢所以關稅上路這一些進口的產品成本一定會上升而最終成本一定轉嫁到民眾身上 |
| transcript.whisperx[14].start |
337.32 |
| transcript.whisperx[14].end |
345.528 |
| transcript.whisperx[14].text |
甚至大家都知道這是剛性需求而你真的沒藥缺藥危及病人的用藥權益知識體大 |
| transcript.whisperx[15].start |
351.761 |
| transcript.whisperx[15].end |
377.935 |
| transcript.whisperx[15].text |
所以這個我們缺藥是因為我們台灣的市場小 利潤低我們只有單一買家叫健保署仰賴特定供應商那一旦進口變貴或者是供應中斷根本找不到替代品那這對長照的病人特別是兒童長者身障 癌症 |
| transcript.whisperx[16].start |
379.198 |
| transcript.whisperx[16].end |
380.181 |
| transcript.whisperx[16].text |
這個衝擊很大 你怎麼會有很多人在問你 你都說要煮成丸丸這樣 |
| transcript.whisperx[17].start |
385.285 |
| transcript.whisperx[17].end |
412.875 |
| transcript.whisperx[17].text |
然後健保 健保問題很大捏健保的財務壓力很大捏 緊繃捏你不是說癌症給付的那個幾十億移出去 公務預算給了就沒問題捏他這個財務壓力這麼大壓縮給付醫生擔心的是點子下降 可是我們擔心的是病人就醫的權益啊 就醫的可敬性會受影響 |
| transcript.whisperx[18].start |
414.884 |
| transcript.whisperx[18].end |
428.109 |
| transcript.whisperx[18].text |
所以台灣的健保制度為了財務平衡已經從區域總額已經改到大醫院你要個別醫院總額制了所以各項的醫療給付都受限於總額的管制一旦採購成本上升藥品成本上升 |
| transcript.whisperx[19].start |
440.029 |
| transcript.whisperx[19].end |
460.818 |
| transcript.whisperx[19].text |
他一定會壓縮到醫生的點子要不然就是醫院面臨經營的壓力所以縮減開支 降低禁藥量降低禁藥量也是影響到用藥人那你沒有降低禁藥量全部都轉嫁費用給病患 |
| transcript.whisperx[20].start |
464.025 |
| transcript.whisperx[20].end |
478.689 |
| transcript.whisperx[20].text |
你這樣什麼都去 掛貨費啊 去部分負擔啊 去大行農莊 去現在再來藥品 這樣是要再去 要再去所以健保才會這麼困難還要承擔 額外承擔關稅上升的額外成本我跟你說 你不是說 你現在都一句話說沒關係 我們學名藥 國藥國用 國產國藥國用你講得太簡單了 |
| transcript.whisperx[21].start |
490.592 |
| transcript.whisperx[21].end |
492.373 |
| transcript.whisperx[21].text |
台灣要做藥學名藥原料都很靠的中國跟印度我們都要中國的比較多中國不會棄價嗎瞬間需求量大增怎麼會不會棄價 |
| transcript.whisperx[22].start |
507.419 |
| transcript.whisperx[22].end |
530.195 |
| transcript.whisperx[22].text |
這個影響衝擊最大的很多人其實有商業保險的有自費能力的可是更多人是偏鄉的低收入戶人長期病患的弱勢族群他們首當其衝他們沒有商業保險醫療領域他是陽剛性需求如果今天癌症用藥缺了不可能叫病人等兩個月 |
| transcript.whisperx[23].start |
532.071 |
| transcript.whisperx[23].end |
548.06 |
| transcript.whisperx[23].text |
是不是 柏定你也說說看 我說這個問題你都認為沒問題嗎報告委員 委員所提的真的都非常的深入跟專業個人表達最大的敬意那你剛剛的問題 其實我們長期在醫藥 醫藥藉 藥藉 醫材藉 |
| transcript.whisperx[24].start |
554.511 |
| transcript.whisperx[24].end |
564.379 |
| transcript.whisperx[24].text |
生醫界都一直在努力希望把我們的一個醫療體系長期在努力在長期被詬病也長期處理不好長期沒有能力應變沒有一下子就滿分但是我們一定好中在好一直在改善我想這個部分經委員也要珍惜我們國內這些醫藥 醫材 特種 |
| transcript.whisperx[25].start |
578.712 |
| transcript.whisperx[25].end |
586.839 |
| transcript.whisperx[25].text |
這麼多同仁在努力的應該給他們鼓勵那我們還做不到的我們繼續來努力他們在期望政府的政策引導他們在期待有政府會做事有政府能帶領有政府可以帶領他們看到到底他們要怎麼應變特別廠商 特別藥商有辦法應變嗎 |
| transcript.whisperx[26].start |
603.413 |
| transcript.whisperx[26].end |
606.635 |
| transcript.whisperx[26].text |
我們的政策一直努力在維持守護人民的健康這是第一個你跟我說 當前仰賴美國進口的藥品和醫材我不是要跟你說幾張藥證啦 |
| transcript.whisperx[27].start |
615.1 |
| transcript.whisperx[27].end |
621.403 |
| transcript.whisperx[27].text |
哪有這麼簡單的來 你看你報告你說我們現在看到美國的藥品有幾種藥精有幾個品項這麼簡單喔可替代我沒有要問你啊我要問你的是無替代性或者是可替代性低但是使用頻率高的有幾個品項有幾張藥證 有哪些用藥你現在回答我是不是食藥水可以 還是 |
| transcript.whisperx[28].start |
643.935 |
| transcript.whisperx[28].end |
660.512 |
| transcript.whisperx[28].text |
食藥署回答我本人的辦公室這裡有寫啦他說除了罕見疾病14張許可證以外所有的適應症的疾病臨床上都有其他藥品可供替代啦所以他現在在歡樂的說他現在在歡樂的都杞人憂天啦 |
| transcript.whisperx[29].start |
662.694 |
| transcript.whisperx[29].end |
671.823 |
| transcript.whisperx[29].text |
我立委現在在問的都杞人憂天 都沒有那個不可替代 除了罕見疾病這是食藥署給我回答的 現在健保署來回答 敢真的這樣食藥署回答林淑芬委員辦公室 她說你放心嘛 美國來的除了罕見疾病 每一種藥都有替代性 都沒有問題 |
| transcript.whisperx[30].start |
687.188 |
| transcript.whisperx[30].end |
709.445 |
| transcript.whisperx[30].text |
健保署你回答看看跟委員報告就是我們從健保給付的品項裡頭屬於美國產地進來的大概是176項啦這176項裡面又是屬於這個食藥署的必要藥品清單的是72項那72項裡面最多的是抗腫瘤藥物我現在沒有講那個我現在問你說 |
| transcript.whisperx[31].start |
710.879 |
| transcript.whisperx[31].end |
719.205 |
| transcript.whisperx[31].text |
無可替代性或替代性很低 但是使用頻率高我不是在問你必要藥品清單多渣食鹽水之論我就跟你說了一生原料短缺 市占不均你盤點給我看 你們也盤點不出來 |
| transcript.whisperx[32].start |
731.349 |
| transcript.whisperx[32].end |
746.502 |
| transcript.whisperx[32].text |
現在我告訴你 美國做的 美國進口進來但是我們不用它 不過沒有替代性或是很少其他國家 其他藥廠在做但是使用頻率高的是哪些藥 |
| transcript.whisperx[33].start |
747.591 |
| transcript.whisperx[33].end |
774.466 |
| transcript.whisperx[33].text |
你回答我跟委員報告這個不能用使用頻率來講使用頻率最多的這些什麼降血壓啦糖尿病的藥那個都有可替代最重要就是我剛剛提到的抗腫瘤的藥物因為很多都在專利期以內那這個呢使用頻率不是很高但是卻是必要藥品被我們列進來但是你食藥署講說除了罕見疾病都沒有了都可以有替代 |
| transcript.whisperx[34].start |
775.799 |
| transcript.whisperx[34].end |
793.364 |
| transcript.whisperx[34].text |
報告委員我們特別提到我們盤出來裡面因為我們這邊對於藥證可以確立出來美國廠製造的藥證美國來的藥證是有214張那這214張裡面假如是在專利期裡面又是單獨的它的替代性就很低因為只有它有而已它有60種 |
| transcript.whisperx[35].start |
795.124 |
| transcript.whisperx[35].end |
812.916 |
| transcript.whisperx[35].text |
你回答我的 你們今天在這裡答的跟書面給我資料的跟今天報告的數據都不一樣你們 我們當初跟你索取資料說自美國進口 製造成立為美國的藥品和醫產清單你告訴我們說 食藥署告訴我說藥品清單150張要證 今天講214張你的書面報告寫215張 健保署講176項 |
| transcript.whisperx[36].start |
821.582 |
| transcript.whisperx[36].end |
844.082 |
| transcript.whisperx[36].text |
報告委員你可誤會了因為它的替代性如果在專利期內的這張有60張它的可替代性幾乎是等於0因為只有它有你在這裡面告訴我只有14張是不可替代其他都有你的公文書在這裡你說只有14張是不可取代其他都有替代14張是罕病 |
| transcript.whisperx[37].start |
845.567 |
| transcript.whisperx[37].end |
858.516 |
| transcript.whisperx[37].text |
你的文字我講除了罕見疾病藥品共14張許可證以外其餘適應症疾病於臨床上有其他藥品可供使用 |
| transcript.whisperx[38].start |
859.52 |
| transcript.whisperx[38].end |
875.5 |
| transcript.whisperx[38].text |
你的公文書都沒有講到癌症專利都還沒過期謝謝委員這邊可以有機會我們可以補充一下我的意思是說立委所知林農青菜公共好回答給立委在這裡在講又不一樣 |
| transcript.whisperx[39].start |
877.117 |
| transcript.whisperx[39].end |
896.203 |
| transcript.whisperx[39].text |
報告委員吼 我們立委的所思真的都很認真昨天說點都江署長還打電話給我說他們前署幾乎都在加班他告訴立委說沒問題啦 沒大事啦 除了署長說趕快放 趕快全部回家 今天你說沒夠感情60張的郵 六十張的郵啊 太辛苦了啊建保署長是幾種 潘哲德應該是非常用心 主席我沒有叫他說 他一直說不知道在說什麼 我也聽不懂 |
| transcript.whisperx[40].start |
902.69 |
| transcript.whisperx[40].end |
920.426 |
| transcript.whisperx[40].text |
這樣健保署 我現在說的是你們每天都退回去了保證你們不會忘記喔前幾天人家受訪時 你表示面對關稅的轉變進口藥品確實是有價格上漲的可能但國內缺藥平台已經非常有經驗健保有因應的制度你剛才在這裡自己說 沒有缺藥漲價之餘喔 |
| transcript.whisperx[41].start |
925.697 |
| transcript.whisperx[41].end |
940.637 |
| transcript.whisperx[41].text |
你受訪跟在裡面你回答你自己就說不一樣啦現在是沒有缺藥但是漲價是有可能但是我們不要我們已經準備好了所以不用太擔心這樣子你剛才回答你以為王育民說沒有缺藥也沒有漲價之餘欸 |
| transcript.whisperx[42].start |
943.24 |
| transcript.whisperx[42].end |
958.648 |
| transcript.whisperx[42].text |
那可能有可能 我的觀念裡面的確是有漲價的可能性我講了早幾次 今天早上我講了好幾次說我一直跟你說 我說了回來從美國進口的無可替代性或替代性使用替代性低 使用頻率高的藥品和醫材這個你們去盤點 到底 雖然有缺藥平台但是即使缺藥平台你們有遇過缺藥的經驗但一直以來缺藥的次數都沒有少過 |
| transcript.whisperx[43].start |
972.762 |
| transcript.whisperx[43].end |
994.712 |
| transcript.whisperx[43].text |
你哪來的信心覺得有缺藥平台就不會發生缺藥危機有缺藥的經驗也不代表可以克服缺藥的危機對吧所以健保署署長來進口清單清單中進口藥品有沒有這個我剛剛講的無可替代 可替代性高 使用頻率高的藥品和藥材各有幾項 |
| transcript.whisperx[44].start |
996.596 |
| transcript.whisperx[44].end |
997.598 |
| transcript.whisperx[44].text |
剛剛我提到從美國進來的在這個必要藥品裡面那個是72項啦 |
| transcript.whisperx[45].start |
1004.827 |
| transcript.whisperx[45].end |
1016.013 |
| transcript.whisperx[45].text |
阿裡面又以抗腫瘤的藥物 不可替代的那這些都是專利 我剛剛提到抗腫瘤你說72項 阿實藥署說60項欸不不不 不是不是 這裡面有的可以替代裡面有的像那個什麼抗生素啦 你到底不可替代的幾項啦這是必要藥品裡面72項啦阿不是全部都不可替代有些還是可以替代 我在問你不可替代的啦 |
| transcript.whisperx[46].start |
1028.439 |
| transcript.whisperx[46].end |
1034.384 |
| transcript.whisperx[46].text |
不可替代最主要就是那些腫瘤藥啊多少項你怎麼要盤點出來讓用藥人讓醫師未來有心理準備吧癌症病患未來可能會欠藥嗎價格大幅上漲嗎這個我們有調整調價的機制 |
| transcript.whisperx[47].start |
1052.32 |
| transcript.whisperx[47].end |
1072.45 |
| transcript.whisperx[47].text |
食藥署署長你們提供的醫材清單不是藥品醫材初步評估各項醫材上有產品或其他療法可替代所以你們還要跟相關醫學會去確認醫材你們從今天的報告然後川普宣布這個4月4號宣布到現在10天了有沒有完成盤點你們要跟醫學會確認到底有沒有醫材是不可替代的盤點完了沒 |
| transcript.whisperx[48].start |
1079.534 |
| transcript.whisperx[48].end |
1094.166 |
| transcript.whisperx[48].text |
跟委員這邊特別報告因為整個醫材使用裡面絕對的所謂必要性的醫材我們有盤了33支必要性的醫材不可避難所以必要性的醫材裡面我們可以看到其中有235張是來自於美國廠的 登記的 |
| transcript.whisperx[49].start |
1098.47 |
| transcript.whisperx[49].end |
1112.401 |
| transcript.whisperx[49].text |
其中有三項必要性的醫材三項必要性的醫材裡面呢共用有八張在占比是大概是0.018%是屬於所以只有三項而已所以只有三項然後可能有八張那個藥證 |
| transcript.whisperx[50].start |
1115.888 |
| transcript.whisperx[50].end |
1126.372 |
| transcript.whisperx[50].text |
所以只有三項我們現在是談他可能沒有辦法替代的絕對的沒辦法替代對第一線裡面謝謝委員這邊提醒你也應該告訴大家第一線的讓他能夠清楚你要讓醫生知道那你要趕快讓使用這醫產的人知道 |
| transcript.whisperx[51].start |
1134.054 |
| transcript.whisperx[51].end |
1154.145 |
| transcript.whisperx[51].text |
那我現在還要講我最後 我其實還有很多但我現在因為時間的關係所以我就不要講那麼多不論是健保署或食藥署你們去盤點出來以後你們有沒有包含癌症的標靶藥物或是類似治療風濕免疫最常使用的生物製劑這些自費品項的藥點在不在你們盤點的清單裡面自費自費沒有盤沒有盤 |
| transcript.whisperx[52].start |
1162.725 |
| transcript.whisperx[52].end |
1179.372 |
| transcript.whisperx[52].text |
我們盤的當然就是以健保給付為主你知道有多少人需要使用這一些東西嗎所以自費的人政府沒有盤點出來你們難道不應該納入嗎那你們真的面對這個關稅的衝擊漲價原料漲價的衝擊連國內學民藥國內藥廠都受到衝擊了更何況從美國的進口的然後自費的沒有盤 |
| transcript.whisperx[53].start |
1189.016 |
| transcript.whisperx[53].end |
1206.343 |
| transcript.whisperx[53].text |
你們真的準備好了嗎現在如果是以標靶要務來看的話我們幾乎都已經納入將近都納入幾戶了啦只是那個幾戶標靶要務將近都納入幾戶幾戶的條件不同啦就是他不是全市一陣子不是啦所以你說的自費指的是我跟你講你知道你賣公共語言來欺騙我們符合資格的納入幾戶不符合資格的也自費再買再用有多少人啊 |
| transcript.whisperx[54].start |
1215.043 |
| transcript.whisperx[54].end |
1226.069 |
| transcript.whisperx[54].text |
有多少人啊你們沒有盤點對這些用藥人應該沒有衝擊而且為什麼還需要自費去用這些生物資金包把藥物就是因為要救命啊最急的比人好人還要急的萬一開集青家大餐開這麼多集就是因為要救命然後這一波會不會受到衝擊政府不知道沒有盤點所以 |
| transcript.whisperx[55].start |
1243.959 |
| transcript.whisperx[55].end |
1263.444 |
| transcript.whisperx[55].text |
我們一直在講盤點評估是要談什麼重點為什麼一直提醒你這個是因為這個剛性需求是要救命的救人救命的還有另外一個議題我還來不及講下一次再講你們要真的要認真準備已經講過那只是哪一期用什麼藥其實也都盤點在裡面你今天說的 |
| transcript.whisperx[56].start |
1273.087 |
| transcript.whisperx[56].end |
1298.679 |
| transcript.whisperx[56].text |
要醫材跟他三行癌症的那個只有60項但願如此喔把那些都公布出來要不要提供給我們讓所有的人都知道用有癌人用的這醫材人他們要清楚知道自己未來面臨的風險和衝擊是什麼這個只是我今天質詢的第一部分抱歉我還有其他但時間來不及所以就下次再談好 謝謝林委員 |