| IVOD_ID |
165444 |
| IVOD_URL |
https://ivod.ly.gov.tw/Play/Clip/1M/165444 |
| 日期 |
2025-11-13 |
| 會議資料.會議代碼 |
委員會-11-4-26-10 |
| 會議資料.會議代碼:str |
第11屆第4會期社會福利及衛生環境委員會第10次全體委員會議 |
| 會議資料.屆 |
11 |
| 會議資料.會期 |
4 |
| 會議資料.會次 |
10 |
| 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4會期社會福利及衛生環境委員會第10次全體委員會議 |
| 影片種類 |
Clip |
| 開始時間 |
2025-11-13T12:48:32+08:00 |
| 結束時間 |
2025-11-13T12:59:08+08:00 |
| 影片長度 |
00:10:36 |
| 支援功能[0] |
ai-transcript |
| video_url |
https://ivod-lyvod.cdn.hinet.net/vod_1/_definst_/mp4:1MClips/fffa2c65c610face2bc23b9359c9933d8ff38efa2589ba0871572932e1d9cfea11b57a280f0214d75ea18f28b6918d91.mp4/playlist.m3u8 |
| 委員名稱 |
廖偉翔 |
| 委員發言時間 |
12:48:32 - 12:59:08 |
| 會議時間 |
2025-11-13T09:00:00+08:00 |
| 會議名稱 |
立法院第11屆第4會期社會福利及衛生環境委員會第10次全體委員會議（事由：邀請衛生福利部部長及行政院主計總處就「癌症新藥暫時性支付及罕見疾病藥物專款預算運用成效及政策檢討」進行專題報告，並備質詢。
(討論事項)
審查
一、委員羅廷瑋等16人擬具「癌症防治法第十三條及第十六條條文修正草案」案。
二、委員陳菁徽等16人擬具「癌症防治法第十六條條文修正草案」案。
三、委員邱鎮軍等19人擬具「癌症防治法第五條及第十六條條文修正草案」案。
四、委員劉建國等17人擬具「癌症防治法第十六條條文修正草案」案。
五、委員王正旭等17人擬具「癌症防治法第十六條條文修正草案」案。
六、委員顏寬恒等21人擬具「癌症防治法第十三條條文修正草案」案。
七、委員林淑芬等20人擬具「癌症防治法第十六條條文修正草案」案。
八、委員盧縣一等17人擬具「癌症防治法第八條及第十六條條文修正草案」案。
九、委員顏寬恒等24人擬具「癌症防治法第十六條條文修正草案」案。
十、委員蘇巧慧等30人擬具「癌症防治法修正草案」案。
十一、委員林月琴等16人擬具「癌症防治法第十六條條文修正草案」案。
十二、委員邱議瑩等16人擬具「癌症防治法第十六條條文修正草案」案。
十三、委員羅智強等18人擬具「癌症防治法第十六條條文修正草案」案。
十四、台灣民眾黨黨團擬具「癌症防治法第一條、第十三條及第十六條條文修正草案」案。
十五、委員陳亭妃等17人擬具「癌症防治法第十六條條文修正草案」案。
十六、委員黃秀芳等21人擬具「癌症防治法第十六條條文修正草案」案。
十七、委員馬文君等16人擬具「癌症防治法第十六條條文修正草案」案。
【專題報告及討論事項綜合詢答；討論事項僅詢答】） |
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謝謝主席謝謝各位那請石部長以及國建署長石部長石的安心廖委員好謝謝石部長這個第一個我想問一下因為根據國建署的這個癌症登記報告跟健保大數據顯示其實攝護腺癌發生個案從 |
| transcript.whisperx[1].start |
24.617 |
| transcript.whisperx[1].end |
52.469 |
| transcript.whisperx[1].text |
2022年9062人那也增加到2024年達到了9858人那他成為男性的第三大癌症而且發生率增加比例最高的癌症那從這個部分來看流行病學的數據這個攝護腺癌的發生率每10萬人大概是41.7人那子宮頸癌是7.6人等於是攝護腺癌是子宮頸癌的5.5倍 |
| transcript.whisperx[2].start |
53.729 |
| transcript.whisperx[2].end |
78.223 |
| transcript.whisperx[2].text |
那攝護腺癌的死亡率呢每10萬人大概是7.8人那也是子宮頸癌2.56人的三倍所以2024年這個攝護腺癌的死亡還將近了2000人1897人所以值得注意的是其實早在2003年攝護腺癌的發生率就超過了子宮頸癌那2005年攝護腺癌的死亡率也大於子宮頸癌 |
| transcript.whisperx[3].start |
79.364 |
| transcript.whisperx[3].end |
93.32 |
| transcript.whisperx[3].text |
那我國從1995年開始就有開始提供30歲以上的女性免費的這個子宮頸抹片檢查但是男性的攝護腺癌的篩檢到現在都沒有納入全民篩檢 |
| transcript.whisperx[4].start |
94.341 |
| transcript.whisperx[4].end |
113.167 |
| transcript.whisperx[4].text |
延遲近30年喔那相較於美國在1988年他們就就是開始進行攝護腺癌的篩檢而且他在幾年內也成功的下降了死亡率喔所以台灣在這部分的篩檢似乎是落後的蠻多想要請問一下為什麼至今沒有想要把它納入公費篩檢的規劃 |
| transcript.whisperx[5].start |
114.141 |
| transcript.whisperx[5].end |
136.695 |
| transcript.whisperx[5].text |
好跟委員說明這個確實這個攝護腺癌隨著我們高齡化年齡的延長這個發生率越來越高那死亡率我們也看到這個還是有一定診斷出來的時候是第四期的攝護腺癌所以死亡率也相對高所以這確實是我們現在在癌症防治上需要有一個國家的政策出來所以我們現在也正在研擬 |
| transcript.whisperx[6].start |
137.395 |
| transcript.whisperx[6].end |
163.437 |
| transcript.whisperx[6].text |
至於說傳統我們常認為是拿來做攝護腺癌指標的PSA因為它的干擾因素多現在很多的國家並還沒有把它列為常規因為它的干擾因素跟判讀會影響到後續會不會因為就不必要的侵入性我覺得部長是這樣其實身邊有很多真的是因為沒有去篩檢所以太晚發現對不對 |
| transcript.whisperx[7].start |
164.878 |
| transcript.whisperx[7].end |
181.142 |
| transcript.whisperx[7].text |
但是现在又有新的就是我们传统只有PSA那现在还有用FreePSA甚至透过那个计算方式去更精准的去区分它是癌或者是良性所以这个我们现在正在请专家做评估 |
| transcript.whisperx[8].start |
181.542 |
| transcript.whisperx[8].end |
198.166 |
| transcript.whisperx[8].text |
未來我們會提出一個關於攝護腺癌所以現在有在評估嘛對不對現在有在評估嘛 納入公費篩檢所以基本上不是因為經費的問題啦主要就是說你們覺得夠不夠精準這樣子那你們有沒有預計什麼時間可不可以在這裡給本席一個時間和方向 |
| transcript.whisperx[9].start |
208.87 |
| transcript.whisperx[9].end |
232.081 |
| transcript.whisperx[9].text |
應該是半年半年之後會確定是不是都會有一個策略所以到時候不見得是透過所謂的PSA可能是你用其他的方式可能要有一個那個protocol就是要有一個流程什麼樣的人怎麼驗出來的紙在哪裡要加驗什麼對啊因為通常可能是PSA然後發現有異常然後再進一步可能不管是這個肛門之症啊或是你說這個相關的其他的 |
| transcript.whisperx[10].start |
233.721 |
| transcript.whisperx[10].end |
262.111 |
| transcript.whisperx[10].text |
對 所以本席想要講的事情是要加速因為其實我有發現在民間可能很少人真的主動去檢查等他發現的時候就已經太晚了所以我是覺得如果可以當然你說現在近期已經有很快有可能有更精準的工具了那當然希望加速那如果不行的話其實就算他所謂的素質有異常可是也是促使他要進一步去檢查這樣還是可以提早知道自己到底在哪一期或甚至沒事沒事那是最好 |
| transcript.whisperx[11].start |
262.931 |
| transcript.whisperx[11].end |
284.045 |
| transcript.whisperx[11].text |
所以本席想要講的是說部長這部分要請你這個禁訴好不好好所以半年內會有消息有沒有可能再加速因為這個是委託學者在做我們給他催催看好再麻煩部長我們盡量快那再來就是有關於罕病專用藥的部分這個115年的罕病專款預算編列方式是有改變的對不對 |
| transcript.whisperx[12].start |
285.66 |
| transcript.whisperx[12].end |
310.821 |
| transcript.whisperx[12].text |
罕要的這個專款預算在115年度這個是153.97億可是他跟罕病基金會的推估的實際需求相比有蠻大的落差那最後你們這個罕病的專款僅編列了136億所以這個大概差了18億嘛那我想這不只是數字上的短缺我覺得他可能更對於這個17627位的罕病家庭 |
| transcript.whisperx[13].start |
314.924 |
| transcript.whisperx[13].end |
337.611 |
| transcript.whisperx[13].text |
是一個無情的打擊所以基金會也指出健保署一反常態沒有依往年以這個近5年的平均成長率推估隔年的罕病罕藥的專款成長率卻改以113年這個已收載之94項的罕藥依令的申報費用乘以近5年的平均成長率 |
| transcript.whisperx[14].start |
338.231 |
| transcript.whisperx[14].end |
362.879 |
| transcript.whisperx[14].text |
所以用這種所謂依令的推估模式是這個至少遺漏了114年新增給付之罕要的費用以及這個專款結算邏輯中應該納入計算之非公告罕要品項所以導致這個預估有重大落差好所以想要請問署長這部分或是部長這部分為什麼今年突然要改變這樣的公式導致有這樣18億的 |
| transcript.whisperx[15].start |
364.912 |
| transcript.whisperx[15].end |
381.894 |
| transcript.whisperx[15].text |
落差跟委員說明這個也是經過目前還在等待要納入的藥去推估出來的所以以現在這樣的預算推估據瞭解是可以把現行申請要進入這個健保給付的含藥應該是足以含納 |
| transcript.whisperx[16].start |
382.995 |
| transcript.whisperx[16].end |
400.261 |
| transcript.whisperx[16].text |
但是這個基金會他們擔心的特性就是不是隨時都要一直出來他可能久久才有一個突破所以我們經過HTA的評估所以你們是特別今年才改變這樣子的算法嗎算法好像也沒有太大的差異也是這樣推估的嘛 |
| transcript.whisperx[17].start |
401.061 |
| transcript.whisperx[17].end |
426.076 |
| transcript.whisperx[17].text |
但是這跟這個罕病基金會過去他們推估因為他們有來澄清說這個是跟他們的過去以往的推估方式是不同的而且有很大的落差的應該是說是按照過去的這個罕病的病人需要用的藥去推估再加上未來要納入的所以他是兩塊併起來所以應該是但是現在114年你們有遺漏114年的新增給複製罕藥費用嗎 |
| transcript.whisperx[18].start |
428.337 |
| transcript.whisperx[18].end |
457.134 |
| transcript.whisperx[18].text |
都有全部納入了所以你們覺得這個部分是跟這個基金會的這個認知是有落差嗎跟委員報告這個10月3號的立法院公聽會之後我們跟罕病病友學會事實上也開了蠻多次會已經充分的解釋清楚目前所有在Horizon scan在等待中的所有藥物等待審議還沒過的所有藥物全部納入以上補充全部都會納入好所以已經跟他們解釋過沒有落差那你們的這個計算方式也沒有改變沒有沒有 |
| transcript.whisperx[19].start |
457.674 |
| transcript.whisperx[19].end |
472.221 |
| transcript.whisperx[19].text |
跟這個委員報告我們也是用過去五年只是說這次是更精準的把94項每一項的成長率分開算這也是公衛學者給我們的建議那關於公視我們已經給韓平但是你們在實務上會不會因此而短少 |
| transcript.whisperx[20].start |
473.962 |
| transcript.whisperx[20].end |
494.716 |
| transcript.whisperx[20].text |
目前海耀基金會認為的房缺是18億那我們目前到明年健保內的額度是192還有另外的公務預算20應該是足以營運以上補充所以20會補進去我們有編載這個我們的公務預算裡頭這樣好 謝謝部長到時候再請委員對 到時候再也提供一個本席說明再來就是 |
| transcript.whisperx[21].start |
495.777 |
| transcript.whisperx[21].end |
515.272 |
| transcript.whisperx[21].text |
百億的新藥基金的部分那我想這個百億癌症基金是賴清德總統也很重要的競選政見那他的目的是要加速引進與給付這個癌症新藥和新療法以應對癌症連續43年為國人為國人的十大死因 |
| transcript.whisperx[22].start |
517.193 |
| transcript.whisperx[22].end |
539.271 |
| transcript.whisperx[22].text |
但是呢這個他的相關的規劃是從2025年起公務預算一柱50億然後2026年再爭取50億所以這個準百億癌症基金卻怎麼樣好像都還沒湊到百億喔那那個時候就說要先用站邊站邊的這個部分然後雖然號稱說未來會逐年增加到底什麼時候才會足爾 |
| transcript.whisperx[23].start |
540.789 |
| transcript.whisperx[23].end |
551.665 |
| transcript.whisperx[23].text |
按照我們的推估 因為今年大概用掉20幾億然後明年50億的公寓算進來會有70億左右那預計大概後年的時候會到達百億 |
| transcript.whisperx[24].start |
552.833 |
| transcript.whisperx[24].end |
581.16 |
| transcript.whisperx[24].text |
你們今天的報告有提到說後續會看相關的需求嘛爭取預算預注嘛那要保持所謂專款經費在一定的水位那請問部長一定的水位到底是指多少因為外界的理解就是不是又是百億嗎那這樣算不算我們未來都會維持因為他是逐步上來因為他要申請審查然後醫院採購使用嘛所以會逐步上來所以未來大概到會維持在至少百億的水準 |
| transcript.whisperx[25].start |
582.04 |
| transcript.whisperx[25].end |
610.617 |
| transcript.whisperx[25].text |
所以你的水準就是百億的水準會維持在百億水準不是說就是剛好一百億啦可能也會超過也不一定我們看看未來的情形這樣對因為這個東西跟一開始大家的理解不同一開始不是應該就是一次到位嗎就是應該一次到位百億結果現在變成一直拖延後延後沒有拖啦就是說大家的理解的百億其實就是最終一定在兩三年內因為它的用藥是逐步上來的 |
| transcript.whisperx[26].start |
610.777 |
| transcript.whisperx[26].end |
629.385 |
| transcript.whisperx[26].text |
所以是先畫一個大餅說我們會到百億但是時間就是後面再來推這樣子我們預估這真的跟外界的期待和落差很大部長沒有我們一開始規劃就是差不多兩三年達到這樣的水準這樣好這個部分我想這裡是所有癌症病友的期待和需求這個請部長要盡速達標會好謝謝好謝謝謝謝委員好謝謝廖召偉謝謝部長 |