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{\"word\": \"我\", \"start\": 684.51, \"end\": 684.67, \"score\": 0.874}, {\"word\": \"們\"}, {\"word\": \"會\"}, {\"word\": \"站\", \"start\": 684.67, \"end\": 684.83, \"score\": 0.874}, {\"word\": \"在\", \"start\": 684.83, \"end\": 685.511, \"score\": 0.976}, {\"word\": \"人\", \"start\": 685.511, \"end\": 685.631, \"score\": 0.985}, {\"word\": \"民\", \"start\": 685.631, \"end\": 685.751, \"score\": 0.841}, {\"word\": \"的\", \"start\": 685.751, \"end\": 686.411, \"score\": 0.999}, {\"word\": \"健\", \"start\": 686.411, \"end\": 686.571, \"score\": 0.882}, {\"word\": \"康\", \"start\": 686.571, \"end\": 687.111, \"score\": 0.996}, {\"word\": \"立\", \"start\": 687.111, \"end\": 688.132, \"score\": 0.943}, {\"word\": \"場\"}, {\"word\": \"來\"}, {\"word\": \"分\", \"start\": 688.132, \"end\": 688.292, \"score\": 0.861}, {\"word\": \"析\", \"start\": 688.292, \"end\": 689.192, \"score\": 0.918}, {\"word\": \"謝\"}, {\"word\": \"謝\"}, {\"word\": \"部\", \"start\": 689.192, \"end\": 689.212, \"score\": 0.086}, {\"word\": \"長\"}, {\"word\": \"謝\"}, {\"word\": \"謝\"}], \"language\": \"zh\"}","srt":"1\n00:00:03,757 --> 00:00:09,109\n好謝謝主席主席好那我們要先請我們的邱部長還有食藥署好了\n\n2\n00:00:14,488 --> 00:00:25,877\n委員好部長好那我根據食藥署的數據全台有效藥品許可證有11454張國產佔72.6%但原料廠有75%至80%是仰賴中國和印度進口那現在美國準備對全球藥品關稅開刀那台灣也有被波及這不是單純的這個出口問題而是藥價缺藥健保產業的適從這個夾擊\n\n3\n00:00:43,590 --> 00:01:06,072\n那實際處方藥廠藥市場進口藥品佔比大概超過6成這代表什麼代表你們的國產比例是紙面數據實際上上藥的架上的藥10包裡面有6包是進口的那我想請問一下所有所以有多少藥品是真的在台灣生產佔比佔比就好\n\n4\n00:01:07,096 --> 00:01:30,785\n這邊跟委員做進一步的報告的確我們現在的原料藥的部分在應用的以中國跟印度的佔比相當相當高分別是27%跟26%所以在這種情形之下我們的原料藥的依存度呢的確是非常非常高的我們必要藥品上清單有大概584項有多少是在台灣生產\n\n5\n00:01:33,132 --> 00:01:56,941\n這部分我可能要精確的確定一下你們是主管機關這個必須要確實掌握因為現在是我認為是全球在重新洗牌我們這個供應鏈全部重新在洗牌所以我們這些東西應該要確實掌握因為這個任何一個主要的來源果出問題我們的醫療系統就會出現缺口對不對\n\n6\n00:01:58,138 --> 00:02:06,290\n所以我看到我爸剛剛你講的如果反映在成本到這個成本反映到藥價上是健保吸收還是我們人民吸收\n\n7\n00:02:12,929 --> 00:02:34,605\n因為我們的健保是單一個保險機構我這樣講問了那麼多你們都好像搞不太清楚狀況因為你們是主要的這個主管機關那所有藥品的製造輸入販賣都必須登錄在藥品許可證的這個資料庫是你們的職責嘛對不對那照理說你們隨時應該都可以查出來隨時都可以查出來\n\n8\n00:02:35,365 --> 00:02:59,025\n那我不希望說這個東西到後來變成一個萬一真的發生了那我們怎麼去面對這個問題這個才是我比較擔心的第一個我們絕對會盡力不要增加人民的就醫的負擔包括要價的一個負擔所以我們很早就做好各種不少是美國的關稅的一個變化我們有強化\n\n9\n00:03:00,206 --> 00:03:15,198\n供應的一個疫情這個一定不能讓他缺藥我有看到你的缺藥平台有做啊可是你的缺藥平台你的缺藥平台等他已經這個數據出來的時候就是已經發生的事情啊對不對我要的是你們在之前能夠確實掌握我們這個藥品的數量謝謝委員的提點\n\n10\n00:03:19,281 --> 00:03:33,397\n因為針對預警的平台我們是西藥劑醫療器材的供應的平台短缺平台平台的登錄其實我們會在藥事法裡面希望在就已經規定在半年內致記的是半年內就提出來所以在\n\n11\n00:03:34,258 --> 00:03:42,545\n提前的時間內在還沒有缺藥之前剛才補充一下我希望你好你講你講製劑的部分其實我們國產的製劑其實佔了73.64%的是屬於國產的那這個部分呢我們化學藥品的部分其實是95.09原料咧\n\n12\n00:03:51,132 --> 00:04:13,950\n那我們原料藥的部分相對是比較低目前的占比只有接近15%左右所以這部分是我們持續在努力的一個地方好啦那我跟你講就是剛剛講這些我希望你能夠確實掌握確實掌握那另外當然缺藥平台很重要可是我認為你們內部應該有一個提早的一個機制不能夠等這個數字顯示出來的時候再來處理\n\n13\n00:04:19,714 --> 00:04:40,639\n另外剛剛講說我們有現在在扶植本土藥廠我們當然就是多了一層保障但是我們可能馬上面臨的問題我們比較擔心說我們的患者會不會受到影響因為你現在才要扶植它並不是那麼快對不對\n\n14\n00:04:42,021 --> 00:05:08,431\n跟委員報告這個剛剛提到的這個我們整個健保有幾副的藥品品項大概一萬四千多種那這裡面呢就如方剛剛提到的70%的量是這個等於是學名藥或者是在台灣製造那30%是靠進口那進口裡面我們最需要掌握的就是在專利期內的因為你這個去扶植都沒有用因為它是專利保護\n\n15\n00:05:09,372 --> 00:05:22,148\n專利保護的品項大概是214項那麼大概金額大概在390億左右然後這裡面呢還有一些是沒有辦法替代品項很少的那這個大概在275項\n\n16\n00:05:25,993 --> 00:05:49,039\n那金額大概在200億左右所以我們才會有特別的編列那個特別預算爭取在特別預算因應未來這個專利期內的這些藥就是6到18個月嘛對不對然後保持那我們健保的一樣是健保去吸收成本嘛那這樣的話健保會不會到時候的壓力又越來越大我們在什麼時候情況下會再做調整\n\n17\n00:05:50,061 --> 00:06:16,988\n當然我們目前是行政院有在這個我們這個因應國際情勢的特別條例特別預算裡頭是有編列給健保200億的這個健保基金來因應這樣的變局啦但是長期來講當然也會造成健保保費的壓力確實是這樣對你現在講的是健保那萬一是自付這個自費的部分呢自費的藥品呢這些部分\n\n18\n00:06:18,308 --> 00:06:47,456\n的成長你們有掌握嗎自費的我們就沒有這樣的資料就沒有資料那萬一博論生病怎麼辦這邊跟委員也進一步說明剛剛有特別提到我們的要自治國產的部分因為國內的市場相對比較小所以有時候是比較供應其實是供需上面需要有很好的調控所以我們特別把所謂的希望做智慧監控的導入在未來在我們的藥事法修法在27之3上面也希望在我們的藥品\n\n19\n00:06:47,976 --> 00:07:16,014\n在有短缺的情況之下都能夠進入我們能夠調控的一個機制之內未來也需要多委員給我們很多的支持好啦我希望不管是健保藥品或者是自費的藥品我希望一步一步都要確實掌握啦因為這些都關乎我們國人的健康那麼台灣不只會藥變貴我這樣看但是我更擔心是這個藥買不到這個更是重點我希望大家能夠把這個螺絲拴緊好不好\n\n20\n00:07:17,779 --> 00:07:26,596\n那再來我請教部長就是我們PM2.5直接影響這個疾病負擔死亡統計與健保支出這是不是衛福部的業務\n\n21\n00:07:30,666 --> 00:07:54,389\n有嗎就是P22.5的死亡統計跟健保的支出那世界衛生組織2019年統計很清楚P2.5造成的過早死亡將近七成是心臟病與中風那14%是慢性阻塞性肺病14%是肺炎另外4%是肺癌所以我先問這個部分我們是衛福部的核心公共衛生問題\n\n22\n00:07:55,563 --> 00:08:20,260\n好我想不管任何的因素影響到健康這是我們衛福部應該要去我們有數據嗎哪一方面的數據就這個部分我們有做過調查嗎影響健康各方面影響健康我想這個這個2023年在那個國際的一個期刊那個Science的研究第一是把PN2.5\n\n23\n00:08:21,081 --> 00:08:34,809\n按照來源分開發現藍莓火力發電的這個PM2.5致死風險是其他來源的2.1倍美國因此每年多死了4萬3千人20年間累積了46萬人這代表\n\n24\n00:08:37,574 --> 00:08:50,493\n在這個所有的這些致命的疾病背後有相當的比例的風險來自於藍莓這種加倍致命的污染源不然我請問你有沒有針對藍莓P2.5做過全國的健康這個衝擊的評估\n\n25\n00:08:56,080 --> 00:09:11,452\n我想過去幾年多年來我也在這邊當過八年的立委幾乎都是在質詢這個問題所以你應該很了解當然我們這個跟環境部跟衛福部都有當然這是跨部會的\n\n26\n00:09:11,992 --> 00:09:36,765\n但是你們這個部分因為一個空污的狀況或PM2.5這個部分它的來源我們要看看它的來源是對啊別人都有在做它的分類都分很清楚第二個就是說要科學的分析科學的分析就是要有足夠的證據力對啊結果你有做嗎拿一兩篇paper就來說不是我現在就是請教你們我們有沒有做就是沒有嘛\n\n27\n00:09:41,460 --> 00:09:54,354\n對不對我們來瞭解國衛院他們現在的應該有相關的一個相關的我不希望這樣國衛院有做那你衛福部不是要掌握嗎這個不是關乎我們國人的健康嗎\n\n28\n00:09:56,359 --> 00:10:16,196\n我們當然是很關心所以我認為啦你的立場跟環境部的立場有時候我們必須要以國人的健康作為出發來去做提點不管他們未來他們要怎麼去這個施政或者他的政策方向怎麼走那至少我們要進到我們衛福部應有的一個立場我這樣講沒錯吧\n\n29\n00:10:18,639 --> 00:10:43,181\n我想空污跟各種疾病的相關相連性它有強弱之別我們都會去看看國內外的文獻來做好我們政策的分析一定要儘量減少對我們民眾的影響我想這個部分是我們基本要去做的事情\n\n30\n00:10:43,962 --> 00:11:09,262\n好啦我是希望我們衛福部盡到自己的這個業務的這個職責不要讓我們台灣人用非發電尤其我們中火它就已經佔了一半以上所以這個部分真的是非常非常嚴重請我們這個主管機關不要這個當作沒事一樣不要要勇於挑戰因為上面的政策是怎麼樣這是一回事那我們\n\n31\n00:11:10,063 --> 00:11:29,212\n的業務我這是我的責任我應該說清楚的我還是希望大家來說清楚好不好對我們會按照科學的根據然後有最好是這樣不要變成這個幫我們這個能源政策化妝好不好我講重點在這裡我們會站在人民的健康立場來分析謝謝部長謝謝\n\n","tsv":"start\tend\ttext\n3757\t9109\t好謝謝主席主席好那我們要先請我們的邱部長還有食藥署好了\n14488\t25877\t委員好部長好那我根據食藥署的數據全台有效藥品許可證有11454張國產佔72.6%但原料廠有75%至80%是仰賴中國和印度進口那現在美國準備對全球藥品關稅開刀那台灣也有被波及這不是單純的這個出口問題而是藥價缺藥健保產業的適從這個夾擊\n43590\t66072\t那實際處方藥廠藥市場進口藥品佔比大概超過6成這代表什麼代表你們的國產比例是紙面數據實際上上藥的架上的藥10包裡面有6包是進口的那我想請問一下所有所以有多少藥品是真的在台灣生產佔比 佔比就好\n67096\t90785\t這邊跟委員做進一步的報告的確我們現在的原料藥的部分在應用的以中國跟印度的佔比相當相當高分別是27%跟26%所以在這種情形之下我們的原料藥的依存度呢的確是非常非常高的我們必要藥品上清單有大概584項有多少是在台灣生產\n93132\t116941\t這部分我可能要精確的確定一下你們是主管機關 這個必須要確實掌握因為現在是 我認為是全球在重新洗牌我們這個供應鏈全部重新在洗牌所以我們這些東西應該要確實掌握因為這個任何一個主要的來源果出問題我們的醫療系統就會出現缺口 對不對\n118138\t126290\t所以我看到我爸剛剛你講的如果反映在成本到這個成本反映到藥價上是健保吸收還是我們人民吸收\n132929\t154605\t因為我們的健保是單一個保險機構我這樣講問了那麼多你們都好像搞不太清楚狀況因為你們是主要的這個主管機關那所有藥品的製造輸入販賣都必須登錄在藥品許可證的這個資料庫是你們的職責嘛對不對那照理說你們隨時應該都可以查出來隨時都可以查出來\n155365\t179025\t那我不希望說這個東西到後來變成一個萬一真的發生了那我們怎麼去面對這個問題這個才是我比較擔心的第一個我們絕對會盡力不要增加人民的就醫的負擔包括要價的一個負擔所以我們很早就做好各種不少是美國的關稅的一個變化我們有強化\n180206\t195198\t供應的一個疫情這個一定不能讓他缺藥我有看到你的缺藥平台有做啊可是你的缺藥平台你的缺藥平台等他已經這個數據出來的時候就是已經發生的事情啊對不對我要的是你們在之前能夠確實掌握我們這個藥品的數量謝謝委員的提點\n199281\t213397\t因為針對預警的平台我們是西藥劑醫療器材的供應的平台短缺平台平台的登錄其實我們會在藥事法裡面希望在就已經規定在半年內致記的是半年內就提出來所以在\n214258\t222545\t提前的時間內在還沒有缺藥之前剛才補充一下我希望你好 你講你講製劑的部分其實我們國產的製劑其實佔了73.64%的是屬於國產的那這個部分呢我們化學藥品的部分其實是95.09原料咧\n231132\t253950\t那我們原料藥的部分相對是比較低目前的占比只有接近15%左右所以這部分是我們持續在努力的一個地方好啦 那我跟你講就是剛剛講這些我希望你能夠確實掌握 確實掌握那另外當然缺藥平台很重要可是我認為你們內部應該有一個提早的一個機制不能夠等這個數字顯示出來的時候再來處理\n259714\t280639\t另外剛剛講說我們有現在在扶植本土藥廠我們當然就是多了一層保障但是我們可能馬上面臨的問題我們比較擔心說我們的患者會不會受到影響因為你現在才要扶植它並不是那麼快 對不對\n282021\t308431\t跟委員報告這個剛剛提到的這個我們整個健保有幾副的藥品品項大概一萬四千多種那這裡面呢就如方剛剛提到的70%的量是這個等於是學名藥或者是在台灣製造那30%是靠進口那進口裡面我們最需要掌握的就是在專利期內的因為你這個去扶植都沒有用因為它是專利保護\n309372\t322148\t專利保護的品項大概是214項那麼大概金額大概在390億左右然後這裡面呢還有一些是沒有辦法替代品項很少的那這個大概在275項\n325993\t349039\t那金額大概在200億左右所以我們才會有特別的編列那個特別預算爭取在特別預算因應未來這個專利期內的這些藥就是6到18個月嘛對不對然後保持那我們健保的一樣是健保去吸收成本嘛那這樣的話健保會不會到時候的壓力又越來越大我們在什麼時候情況下會再做調整\n350061\t376988\t當然我們目前是行政院有在這個我們這個因應國際情勢的特別條例特別預算裡頭是有編列給健保200億的這個健保基金來因應這樣的變局啦但是長期來講當然也會造成健保保費的壓力確實是這樣對你現在講的是健保那萬一是自付這個自費的部分呢自費的藥品呢這些部分\n378308\t407456\t的成長你們有掌握嗎自費的我們就沒有這樣的資料就沒有資料那萬一博論生病怎麼辦這邊跟委員也進一步說明剛剛有特別提到我們的要自治國產的部分因為國內的市場相對比較小所以有時候是比較供應其實是供需上面需要有很好的調控所以我們特別把所謂的希望做智慧監控的導入在未來在我們的藥事法修法在27之3上面也希望在我們的藥品\n407976\t436014\t在有短缺的情況之下都能夠進入我們能夠調控的一個機制之內未來也需要多委員給我們很多的支持好啦我希望不管是健保藥品或者是自費的藥品我希望一步一步都要確實掌握啦因為這些都關乎我們國人的健康那麼台灣不只會藥變貴我這樣看但是我更擔心是這個藥買不到這個更是重點我希望大家能夠把這個螺絲拴緊好不好\n437779\t446596\t那再來我請教部長就是我們PM2.5直接影響這個疾病負擔死亡統計與健保支出這是不是衛福部的業務\n450666\t474389\t有嗎就是P2 2.5的死亡統計跟健保的支出那世界衛生組織2019年統計很清楚P2.5造成的過早死亡將近七成是心臟病與中風那14%是慢性阻塞性肺病14%是肺炎另外4%是肺癌所以我先問這個部分我們是衛福部的核心公共衛生問題\n475563\t500260\t好 我想不管任何的因素影響到健康這是我們衛福部應該要去我們有數據嗎哪一方面的數據就這個部分 我們有做過調查嗎影響健康 各方面影響健康我想這個這個2023年在那個國際的一個期刊那個Science的研究第一是把PN2.5\n501081\t514809\t按照來源分開發現藍莓火力發電的這個PM2.5致死風險是其他來源的2.1倍美國因此每年多死了4萬3千人20年間累積了46萬人 這代表\n517574\t530493\t在這個所有的這些致命的疾病背後有相當的比例的風險來自於藍莓這種加倍致命的污染源不然我請問你有沒有針對藍莓P2.5做過全國的健康這個衝擊的評估\n536080\t551452\t我想過去幾年多年來我也在這邊當過八年的立委幾乎都是在質詢這個問題所以你應該很了解當然我們這個跟環境部跟衛福部都有當然這是跨部會的\n551992\t576765\t但是你們這個部分因為一個空污的狀況或PM2.5這個部分它的來源我們要看看它的來源是對啊 別人都有在做它的分類都分很清楚第二個就是說要科學的分析科學的分析就是要有足夠的證據力對啊 結果你有做嗎拿一兩篇paper就來說不是 我現在就是請教你們我們有沒有做就是沒有嘛\n581460\t594354\t對不對我們來瞭解國衛院他們現在的應該有相關的一個相關的我不希望這樣國衛院有做那你衛福部不是要掌握嗎這個不是關乎我們國人的健康嗎\n596359\t616196\t我們當然是很關心所以我認為啦你的立場跟環境部的立場有時候我們必須要以國人的健康作為出發來去做提點不管他們未來他們要怎麼去這個施政或者他的政策方向怎麼走那至少我們要進到我們衛福部應有的一個立場我這樣講沒錯吧\n618639\t643181\t我想空污跟各種疾病的相關相連性它有強弱之別我們都會去看看國內外的文獻來做好我們政策的分析一定要儘量減少對我們民眾的影響我想這個部分是我們基本要去做的事情\n643962\t669262\t好啦 我是希望我們衛福部盡到自己的這個業務的這個職責不要讓我們台灣人用非發電尤其我們中火它就已經佔了一半以上所以這個部分真的是非常非常嚴重請我們這個主管機關不要這個當作沒事一樣不要 要勇於挑戰因為上面的政策是怎麼樣 這是一回事那我們\n670063\t689212\t的業務我這是我的責任我應該說清楚的我還是希望大家來說清楚好不好對我們會按照科學的根據然後有最好是這樣不要變成這個幫我們這個能源政策化妝好不好我講重點在這裡我們會站在人民的健康立場來分析謝謝部長謝謝\n","txt":"好謝謝主席主席好那我們要先請我們的邱部長還有食藥署好了\n委員好部長好那我根據食藥署的數據全台有效藥品許可證有11454張國產佔72.6%但原料廠有75%至80%是仰賴中國和印度進口那現在美國準備對全球藥品關稅開刀那台灣也有被波及這不是單純的這個出口問題而是藥價缺藥健保產業的適從這個夾擊\n那實際處方藥廠藥市場進口藥品佔比大概超過6成這代表什麼代表你們的國產比例是紙面數據實際上上藥的架上的藥10包裡面有6包是進口的那我想請問一下所有所以有多少藥品是真的在台灣生產佔比 佔比就好\n這邊跟委員做進一步的報告的確我們現在的原料藥的部分在應用的以中國跟印度的佔比相當相當高分別是27%跟26%所以在這種情形之下我們的原料藥的依存度呢的確是非常非常高的我們必要藥品上清單有大概584項有多少是在台灣生產\n這部分我可能要精確的確定一下你們是主管機關 這個必須要確實掌握因為現在是 我認為是全球在重新洗牌我們這個供應鏈全部重新在洗牌所以我們這些東西應該要確實掌握因為這個任何一個主要的來源果出問題我們的醫療系統就會出現缺口 對不對\n所以我看到我爸剛剛你講的如果反映在成本到這個成本反映到藥價上是健保吸收還是我們人民吸收\n因為我們的健保是單一個保險機構我這樣講問了那麼多你們都好像搞不太清楚狀況因為你們是主要的這個主管機關那所有藥品的製造輸入販賣都必須登錄在藥品許可證的這個資料庫是你們的職責嘛對不對那照理說你們隨時應該都可以查出來隨時都可以查出來\n那我不希望說這個東西到後來變成一個萬一真的發生了那我們怎麼去面對這個問題這個才是我比較擔心的第一個我們絕對會盡力不要增加人民的就醫的負擔包括要價的一個負擔所以我們很早就做好各種不少是美國的關稅的一個變化我們有強化\n供應的一個疫情這個一定不能讓他缺藥我有看到你的缺藥平台有做啊可是你的缺藥平台你的缺藥平台等他已經這個數據出來的時候就是已經發生的事情啊對不對我要的是你們在之前能夠確實掌握我們這個藥品的數量謝謝委員的提點\n因為針對預警的平台我們是西藥劑醫療器材的供應的平台短缺平台平台的登錄其實我們會在藥事法裡面希望在就已經規定在半年內致記的是半年內就提出來所以在\n提前的時間內在還沒有缺藥之前剛才補充一下我希望你好 你講你講製劑的部分其實我們國產的製劑其實佔了73.64%的是屬於國產的那這個部分呢我們化學藥品的部分其實是95.09原料咧\n那我們原料藥的部分相對是比較低目前的占比只有接近15%左右所以這部分是我們持續在努力的一個地方好啦 那我跟你講就是剛剛講這些我希望你能夠確實掌握 確實掌握那另外當然缺藥平台很重要可是我認為你們內部應該有一個提早的一個機制不能夠等這個數字顯示出來的時候再來處理\n另外剛剛講說我們有現在在扶植本土藥廠我們當然就是多了一層保障但是我們可能馬上面臨的問題我們比較擔心說我們的患者會不會受到影響因為你現在才要扶植它並不是那麼快 對不對\n跟委員報告這個剛剛提到的這個我們整個健保有幾副的藥品品項大概一萬四千多種那這裡面呢就如方剛剛提到的70%的量是這個等於是學名藥或者是在台灣製造那30%是靠進口那進口裡面我們最需要掌握的就是在專利期內的因為你這個去扶植都沒有用因為它是專利保護\n專利保護的品項大概是214項那麼大概金額大概在390億左右然後這裡面呢還有一些是沒有辦法替代品項很少的那這個大概在275項\n那金額大概在200億左右所以我們才會有特別的編列那個特別預算爭取在特別預算因應未來這個專利期內的這些藥就是6到18個月嘛對不對然後保持那我們健保的一樣是健保去吸收成本嘛那這樣的話健保會不會到時候的壓力又越來越大我們在什麼時候情況下會再做調整\n當然我們目前是行政院有在這個我們這個因應國際情勢的特別條例特別預算裡頭是有編列給健保200億的這個健保基金來因應這樣的變局啦但是長期來講當然也會造成健保保費的壓力確實是這樣對你現在講的是健保那萬一是自付這個自費的部分呢自費的藥品呢這些部分\n的成長你們有掌握嗎自費的我們就沒有這樣的資料就沒有資料那萬一博論生病怎麼辦這邊跟委員也進一步說明剛剛有特別提到我們的要自治國產的部分因為國內的市場相對比較小所以有時候是比較供應其實是供需上面需要有很好的調控所以我們特別把所謂的希望做智慧監控的導入在未來在我們的藥事法修法在27之3上面也希望在我們的藥品\n在有短缺的情況之下都能夠進入我們能夠調控的一個機制之內未來也需要多委員給我們很多的支持好啦我希望不管是健保藥品或者是自費的藥品我希望一步一步都要確實掌握啦因為這些都關乎我們國人的健康那麼台灣不只會藥變貴我這樣看但是我更擔心是這個藥買不到這個更是重點我希望大家能夠把這個螺絲拴緊好不好\n那再來我請教部長就是我們PM2.5直接影響這個疾病負擔死亡統計與健保支出這是不是衛福部的業務\n有嗎就是P2 2.5的死亡統計跟健保的支出那世界衛生組織2019年統計很清楚P2.5造成的過早死亡將近七成是心臟病與中風那14%是慢性阻塞性肺病14%是肺炎另外4%是肺癌所以我先問這個部分我們是衛福部的核心公共衛生問題\n好 我想不管任何的因素影響到健康這是我們衛福部應該要去我們有數據嗎哪一方面的數據就這個部分 我們有做過調查嗎影響健康 各方面影響健康我想這個這個2023年在那個國際的一個期刊那個Science的研究第一是把PN2.5\n按照來源分開發現藍莓火力發電的這個PM2.5致死風險是其他來源的2.1倍美國因此每年多死了4萬3千人20年間累積了46萬人 這代表\n在這個所有的這些致命的疾病背後有相當的比例的風險來自於藍莓這種加倍致命的污染源不然我請問你有沒有針對藍莓P2.5做過全國的健康這個衝擊的評估\n我想過去幾年多年來我也在這邊當過八年的立委幾乎都是在質詢這個問題所以你應該很了解當然我們這個跟環境部跟衛福部都有當然這是跨部會的\n但是你們這個部分因為一個空污的狀況或PM2.5這個部分它的來源我們要看看它的來源是對啊 別人都有在做它的分類都分很清楚第二個就是說要科學的分析科學的分析就是要有足夠的證據力對啊 結果你有做嗎拿一兩篇paper就來說不是 我現在就是請教你們我們有沒有做就是沒有嘛\n對不對我們來瞭解國衛院他們現在的應該有相關的一個相關的我不希望這樣國衛院有做那你衛福部不是要掌握嗎這個不是關乎我們國人的健康嗎\n我們當然是很關心所以我認為啦你的立場跟環境部的立場有時候我們必須要以國人的健康作為出發來去做提點不管他們未來他們要怎麼去這個施政或者他的政策方向怎麼走那至少我們要進到我們衛福部應有的一個立場我這樣講沒錯吧\n我想空污跟各種疾病的相關相連性它有強弱之別我們都會去看看國內外的文獻來做好我們政策的分析一定要儘量減少對我們民眾的影響我想這個部分是我們基本要去做的事情\n好啦 我是希望我們衛福部盡到自己的這個業務的這個職責不要讓我們台灣人用非發電尤其我們中火它就已經佔了一半以上所以這個部分真的是非常非常嚴重請我們這個主管機關不要這個當作沒事一樣不要 要勇於挑戰因為上面的政策是怎麼樣 這是一回事那我們\n的業務我這是我的責任我應該說清楚的我還是希望大家來說清楚好不好對我們會按照科學的根據然後有最好是這樣不要變成這個幫我們這個能源政策化妝好不好我講重點在這裡我們會站在人民的健康立場來分析謝謝部長謝謝\n","vtt":"WEBVTT\n\n00:03.757 --> 00:09.109\n好謝謝主席主席好那我們要先請我們的邱部長還有食藥署好了\n\n00:14.488 --> 00:25.877\n委員好部長好那我根據食藥署的數據全台有效藥品許可證有11454張國產佔72.6%但原料廠有75%至80%是仰賴中國和印度進口那現在美國準備對全球藥品關稅開刀那台灣也有被波及這不是單純的這個出口問題而是藥價缺藥健保產業的適從這個夾擊\n\n00:43.590 --> 01:06.072\n那實際處方藥廠藥市場進口藥品佔比大概超過6成這代表什麼代表你們的國產比例是紙面數據實際上上藥的架上的藥10包裡面有6包是進口的那我想請問一下所有所以有多少藥品是真的在台灣生產佔比佔比就好\n\n01:07.096 --> 01:30.785\n這邊跟委員做進一步的報告的確我們現在的原料藥的部分在應用的以中國跟印度的佔比相當相當高分別是27%跟26%所以在這種情形之下我們的原料藥的依存度呢的確是非常非常高的我們必要藥品上清單有大概584項有多少是在台灣生產\n\n01:33.132 --> 01:56.941\n這部分我可能要精確的確定一下你們是主管機關這個必須要確實掌握因為現在是我認為是全球在重新洗牌我們這個供應鏈全部重新在洗牌所以我們這些東西應該要確實掌握因為這個任何一個主要的來源果出問題我們的醫療系統就會出現缺口對不對\n\n01:58.138 --> 02:06.290\n所以我看到我爸剛剛你講的如果反映在成本到這個成本反映到藥價上是健保吸收還是我們人民吸收\n\n02:12.929 --> 02:34.605\n因為我們的健保是單一個保險機構我這樣講問了那麼多你們都好像搞不太清楚狀況因為你們是主要的這個主管機關那所有藥品的製造輸入販賣都必須登錄在藥品許可證的這個資料庫是你們的職責嘛對不對那照理說你們隨時應該都可以查出來隨時都可以查出來\n\n02:35.365 --> 02:59.025\n那我不希望說這個東西到後來變成一個萬一真的發生了那我們怎麼去面對這個問題這個才是我比較擔心的第一個我們絕對會盡力不要增加人民的就醫的負擔包括要價的一個負擔所以我們很早就做好各種不少是美國的關稅的一個變化我們有強化\n\n03:00.206 --> 03:15.198\n供應的一個疫情這個一定不能讓他缺藥我有看到你的缺藥平台有做啊可是你的缺藥平台你的缺藥平台等他已經這個數據出來的時候就是已經發生的事情啊對不對我要的是你們在之前能夠確實掌握我們這個藥品的數量謝謝委員的提點\n\n03:19.281 --> 03:33.397\n因為針對預警的平台我們是西藥劑醫療器材的供應的平台短缺平台平台的登錄其實我們會在藥事法裡面希望在就已經規定在半年內致記的是半年內就提出來所以在\n\n03:34.258 --> 03:42.545\n提前的時間內在還沒有缺藥之前剛才補充一下我希望你好你講你講製劑的部分其實我們國產的製劑其實佔了73.64%的是屬於國產的那這個部分呢我們化學藥品的部分其實是95.09原料咧\n\n03:51.132 --> 04:13.950\n那我們原料藥的部分相對是比較低目前的占比只有接近15%左右所以這部分是我們持續在努力的一個地方好啦那我跟你講就是剛剛講這些我希望你能夠確實掌握確實掌握那另外當然缺藥平台很重要可是我認為你們內部應該有一個提早的一個機制不能夠等這個數字顯示出來的時候再來處理\n\n04:19.714 --> 04:40.639\n另外剛剛講說我們有現在在扶植本土藥廠我們當然就是多了一層保障但是我們可能馬上面臨的問題我們比較擔心說我們的患者會不會受到影響因為你現在才要扶植它並不是那麼快對不對\n\n04:42.021 --> 05:08.431\n跟委員報告這個剛剛提到的這個我們整個健保有幾副的藥品品項大概一萬四千多種那這裡面呢就如方剛剛提到的70%的量是這個等於是學名藥或者是在台灣製造那30%是靠進口那進口裡面我們最需要掌握的就是在專利期內的因為你這個去扶植都沒有用因為它是專利保護\n\n05:09.372 --> 05:22.148\n專利保護的品項大概是214項那麼大概金額大概在390億左右然後這裡面呢還有一些是沒有辦法替代品項很少的那這個大概在275項\n\n05:25.993 --> 05:49.039\n那金額大概在200億左右所以我們才會有特別的編列那個特別預算爭取在特別預算因應未來這個專利期內的這些藥就是6到18個月嘛對不對然後保持那我們健保的一樣是健保去吸收成本嘛那這樣的話健保會不會到時候的壓力又越來越大我們在什麼時候情況下會再做調整\n\n05:50.061 --> 06:16.988\n當然我們目前是行政院有在這個我們這個因應國際情勢的特別條例特別預算裡頭是有編列給健保200億的這個健保基金來因應這樣的變局啦但是長期來講當然也會造成健保保費的壓力確實是這樣對你現在講的是健保那萬一是自付這個自費的部分呢自費的藥品呢這些部分\n\n06:18.308 --> 06:47.456\n的成長你們有掌握嗎自費的我們就沒有這樣的資料就沒有資料那萬一博論生病怎麼辦這邊跟委員也進一步說明剛剛有特別提到我們的要自治國產的部分因為國內的市場相對比較小所以有時候是比較供應其實是供需上面需要有很好的調控所以我們特別把所謂的希望做智慧監控的導入在未來在我們的藥事法修法在27之3上面也希望在我們的藥品\n\n06:47.976 --> 07:16.014\n在有短缺的情況之下都能夠進入我們能夠調控的一個機制之內未來也需要多委員給我們很多的支持好啦我希望不管是健保藥品或者是自費的藥品我希望一步一步都要確實掌握啦因為這些都關乎我們國人的健康那麼台灣不只會藥變貴我這樣看但是我更擔心是這個藥買不到這個更是重點我希望大家能夠把這個螺絲拴緊好不好\n\n07:17.779 --> 07:26.596\n那再來我請教部長就是我們PM2.5直接影響這個疾病負擔死亡統計與健保支出這是不是衛福部的業務\n\n07:30.666 --> 07:54.389\n有嗎就是P22.5的死亡統計跟健保的支出那世界衛生組織2019年統計很清楚P2.5造成的過早死亡將近七成是心臟病與中風那14%是慢性阻塞性肺病14%是肺炎另外4%是肺癌所以我先問這個部分我們是衛福部的核心公共衛生問題\n\n07:55.563 --> 08:20.260\n好我想不管任何的因素影響到健康這是我們衛福部應該要去我們有數據嗎哪一方面的數據就這個部分我們有做過調查嗎影響健康各方面影響健康我想這個這個2023年在那個國際的一個期刊那個Science的研究第一是把PN2.5\n\n08:21.081 --> 08:34.809\n按照來源分開發現藍莓火力發電的這個PM2.5致死風險是其他來源的2.1倍美國因此每年多死了4萬3千人20年間累積了46萬人這代表\n\n08:37.574 --> 08:50.493\n在這個所有的這些致命的疾病背後有相當的比例的風險來自於藍莓這種加倍致命的污染源不然我請問你有沒有針對藍莓P2.5做過全國的健康這個衝擊的評估\n\n08:56.080 --> 09:11.452\n我想過去幾年多年來我也在這邊當過八年的立委幾乎都是在質詢這個問題所以你應該很了解當然我們這個跟環境部跟衛福部都有當然這是跨部會的\n\n09:11.992 --> 09:36.765\n但是你們這個部分因為一個空污的狀況或PM2.5這個部分它的來源我們要看看它的來源是對啊別人都有在做它的分類都分很清楚第二個就是說要科學的分析科學的分析就是要有足夠的證據力對啊結果你有做嗎拿一兩篇paper就來說不是我現在就是請教你們我們有沒有做就是沒有嘛\n\n09:41.460 --> 09:54.354\n對不對我們來瞭解國衛院他們現在的應該有相關的一個相關的我不希望這樣國衛院有做那你衛福部不是要掌握嗎這個不是關乎我們國人的健康嗎\n\n09:56.359 --> 10:16.196\n我們當然是很關心所以我認為啦你的立場跟環境部的立場有時候我們必須要以國人的健康作為出發來去做提點不管他們未來他們要怎麼去這個施政或者他的政策方向怎麼走那至少我們要進到我們衛福部應有的一個立場我這樣講沒錯吧\n\n10:18.639 --> 10:43.181\n我想空污跟各種疾病的相關相連性它有強弱之別我們都會去看看國內外的文獻來做好我們政策的分析一定要儘量減少對我們民眾的影響我想這個部分是我們基本要去做的事情\n\n10:43.962 --> 11:09.262\n好啦我是希望我們衛福部盡到自己的這個業務的這個職責不要讓我們台灣人用非發電尤其我們中火它就已經佔了一半以上所以這個部分真的是非常非常嚴重請我們這個主管機關不要這個當作沒事一樣不要要勇於挑戰因為上面的政策是怎麼樣這是一回事那我們\n\n11:10.063 --> 11:29.212\n的業務我這是我的責任我應該說清楚的我還是希望大家來說清楚好不好對我們會按照科學的根據然後有最好是這樣不要變成這個幫我們這個能源政策化妝好不好我講重點在這裡我們會站在人民的健康立場來分析謝謝部長謝謝\n\n","segments":[{"start":3.757,"end":9.109,"text":"好謝謝主席主席好那我們要先請我們的邱部長還有食藥署好了"},{"start":14.488,"end":25.877,"text":"委員好部長好那我根據食藥署的數據全台有效藥品許可證有11454張國產佔72.6%但原料廠有75%至80%是仰賴中國和印度進口那現在美國準備對全球藥品關稅開刀那台灣也有被波及這不是單純的這個出口問題而是藥價缺藥健保產業的適從這個夾擊"},{"start":43.59,"end":66.072,"text":"那實際處方藥廠藥市場進口藥品佔比大概超過6成這代表什麼代表你們的國產比例是紙面數據實際上上藥的架上的藥10包裡面有6包是進口的那我想請問一下所有所以有多少藥品是真的在台灣生產佔比 佔比就好"},{"start":67.096,"end":90.785,"text":"這邊跟委員做進一步的報告的確我們現在的原料藥的部分在應用的以中國跟印度的佔比相當相當高分別是27%跟26%所以在這種情形之下我們的原料藥的依存度呢的確是非常非常高的我們必要藥品上清單有大概584項有多少是在台灣生產"},{"start":93.132,"end":116.941,"text":"這部分我可能要精確的確定一下你們是主管機關 這個必須要確實掌握因為現在是 我認為是全球在重新洗牌我們這個供應鏈全部重新在洗牌所以我們這些東西應該要確實掌握因為這個任何一個主要的來源果出問題我們的醫療系統就會出現缺口 對不對"},{"start":118.138,"end":126.29,"text":"所以我看到我爸剛剛你講的如果反映在成本到這個成本反映到藥價上是健保吸收還是我們人民吸收"},{"start":132.929,"end":154.605,"text":"因為我們的健保是單一個保險機構我這樣講問了那麼多你們都好像搞不太清楚狀況因為你們是主要的這個主管機關那所有藥品的製造輸入販賣都必須登錄在藥品許可證的這個資料庫是你們的職責嘛對不對那照理說你們隨時應該都可以查出來隨時都可以查出來"},{"start":155.365,"end":179.025,"text":"那我不希望說這個東西到後來變成一個萬一真的發生了那我們怎麼去面對這個問題這個才是我比較擔心的第一個我們絕對會盡力不要增加人民的就醫的負擔包括要價的一個負擔所以我們很早就做好各種不少是美國的關稅的一個變化我們有強化"},{"start":180.206,"end":195.198,"text":"供應的一個疫情這個一定不能讓他缺藥我有看到你的缺藥平台有做啊可是你的缺藥平台你的缺藥平台等他已經這個數據出來的時候就是已經發生的事情啊對不對我要的是你們在之前能夠確實掌握我們這個藥品的數量謝謝委員的提點"},{"start":199.281,"end":213.397,"text":"因為針對預警的平台我們是西藥劑醫療器材的供應的平台短缺平台平台的登錄其實我們會在藥事法裡面希望在就已經規定在半年內致記的是半年內就提出來所以在"},{"start":214.258,"end":222.545,"text":"提前的時間內在還沒有缺藥之前剛才補充一下我希望你好 你講你講製劑的部分其實我們國產的製劑其實佔了73.64%的是屬於國產的那這個部分呢我們化學藥品的部分其實是95.09原料咧"},{"start":231.132,"end":253.95,"text":"那我們原料藥的部分相對是比較低目前的占比只有接近15%左右所以這部分是我們持續在努力的一個地方好啦 那我跟你講就是剛剛講這些我希望你能夠確實掌握 確實掌握那另外當然缺藥平台很重要可是我認為你們內部應該有一個提早的一個機制不能夠等這個數字顯示出來的時候再來處理"},{"start":259.714,"end":280.639,"text":"另外剛剛講說我們有現在在扶植本土藥廠我們當然就是多了一層保障但是我們可能馬上面臨的問題我們比較擔心說我們的患者會不會受到影響因為你現在才要扶植它並不是那麼快 對不對"},{"start":282.021,"end":308.431,"text":"跟委員報告這個剛剛提到的這個我們整個健保有幾副的藥品品項大概一萬四千多種那這裡面呢就如方剛剛提到的70%的量是這個等於是學名藥或者是在台灣製造那30%是靠進口那進口裡面我們最需要掌握的就是在專利期內的因為你這個去扶植都沒有用因為它是專利保護"},{"start":309.372,"end":322.148,"text":"專利保護的品項大概是214項那麼大概金額大概在390億左右然後這裡面呢還有一些是沒有辦法替代品項很少的那這個大概在275項"},{"start":325.993,"end":349.039,"text":"那金額大概在200億左右所以我們才會有特別的編列那個特別預算爭取在特別預算因應未來這個專利期內的這些藥就是6到18個月嘛對不對然後保持那我們健保的一樣是健保去吸收成本嘛那這樣的話健保會不會到時候的壓力又越來越大我們在什麼時候情況下會再做調整"},{"start":350.061,"end":376.988,"text":"當然我們目前是行政院有在這個我們這個因應國際情勢的特別條例特別預算裡頭是有編列給健保200億的這個健保基金來因應這樣的變局啦但是長期來講當然也會造成健保保費的壓力確實是這樣對你現在講的是健保那萬一是自付這個自費的部分呢自費的藥品呢這些部分"},{"start":378.308,"end":407.456,"text":"的成長你們有掌握嗎自費的我們就沒有這樣的資料就沒有資料那萬一博論生病怎麼辦這邊跟委員也進一步說明剛剛有特別提到我們的要自治國產的部分因為國內的市場相對比較小所以有時候是比較供應其實是供需上面需要有很好的調控所以我們特別把所謂的希望做智慧監控的導入在未來在我們的藥事法修法在27之3上面也希望在我們的藥品"},{"start":407.976,"end":436.014,"text":"在有短缺的情況之下都能夠進入我們能夠調控的一個機制之內未來也需要多委員給我們很多的支持好啦我希望不管是健保藥品或者是自費的藥品我希望一步一步都要確實掌握啦因為這些都關乎我們國人的健康那麼台灣不只會藥變貴我這樣看但是我更擔心是這個藥買不到這個更是重點我希望大家能夠把這個螺絲拴緊好不好"},{"start":437.779,"end":446.596,"text":"那再來我請教部長就是我們PM2.5直接影響這個疾病負擔死亡統計與健保支出這是不是衛福部的業務"},{"start":450.666,"end":474.389,"text":"有嗎就是P2 2.5的死亡統計跟健保的支出那世界衛生組織2019年統計很清楚P2.5造成的過早死亡將近七成是心臟病與中風那14%是慢性阻塞性肺病14%是肺炎另外4%是肺癌所以我先問這個部分我們是衛福部的核心公共衛生問題"},{"start":475.563,"end":500.26,"text":"好 我想不管任何的因素影響到健康這是我們衛福部應該要去我們有數據嗎哪一方面的數據就這個部分 我們有做過調查嗎影響健康 各方面影響健康我想這個這個2023年在那個國際的一個期刊那個Science的研究第一是把PN2.5"},{"start":501.081,"end":514.809,"text":"按照來源分開發現藍莓火力發電的這個PM2.5致死風險是其他來源的2.1倍美國因此每年多死了4萬3千人20年間累積了46萬人 這代表"},{"start":517.574,"end":530.493,"text":"在這個所有的這些致命的疾病背後有相當的比例的風險來自於藍莓這種加倍致命的污染源不然我請問你有沒有針對藍莓P2.5做過全國的健康這個衝擊的評估"},{"start":536.08,"end":551.452,"text":"我想過去幾年多年來我也在這邊當過八年的立委幾乎都是在質詢這個問題所以你應該很了解當然我們這個跟環境部跟衛福部都有當然這是跨部會的"},{"start":551.992,"end":576.765,"text":"但是你們這個部分因為一個空污的狀況或PM2.5這個部分它的來源我們要看看它的來源是對啊 別人都有在做它的分類都分很清楚第二個就是說要科學的分析科學的分析就是要有足夠的證據力對啊 結果你有做嗎拿一兩篇paper就來說不是 我現在就是請教你們我們有沒有做就是沒有嘛"},{"start":581.46,"end":594.354,"text":"對不對我們來瞭解國衛院他們現在的應該有相關的一個相關的我不希望這樣國衛院有做那你衛福部不是要掌握嗎這個不是關乎我們國人的健康嗎"},{"start":596.359,"end":616.196,"text":"我們當然是很關心所以我認為啦你的立場跟環境部的立場有時候我們必須要以國人的健康作為出發來去做提點不管他們未來他們要怎麼去這個施政或者他的政策方向怎麼走那至少我們要進到我們衛福部應有的一個立場我這樣講沒錯吧"},{"start":618.639,"end":643.181,"text":"我想空污跟各種疾病的相關相連性它有強弱之別我們都會去看看國內外的文獻來做好我們政策的分析一定要儘量減少對我們民眾的影響我想這個部分是我們基本要去做的事情"},{"start":643.962,"end":669.262,"text":"好啦 我是希望我們衛福部盡到自己的這個業務的這個職責不要讓我們台灣人用非發電尤其我們中火它就已經佔了一半以上所以這個部分真的是非常非常嚴重請我們這個主管機關不要這個當作沒事一樣不要 要勇於挑戰因為上面的政策是怎麼樣 這是一回事那我們"},{"start":670.063,"end":689.212,"text":"的業務我這是我的責任我應該說清楚的我還是希望大家來說清楚好不好對我們會按照科學的根據然後有最好是這樣不要變成這個幫我們這個能源政策化妝好不好我講重點在這裡我們會站在人民的健康立場來分析謝謝部長謝謝"}]}}},"gazette":{"lineno":332,"blocks":[["邱委員鎮軍：（10時1分）謝謝主席，主席好。先請我們的邱部長，還有食藥署。"],["邱部長泰源：委員好。"],["邱委員鎮軍：部長好。根據食藥署的數據，全臺有效藥品許可證有1萬1,454張，其中國產占72.6%，但原料廠有75%至80%是仰賴中國和印度進口，現在美國準備對全球藥品關稅開刀，臺灣也遭受波及，這不是單純出口的問題，而是藥價、缺藥、健保、產業的四重夾擊，實際處方藥市場的進口藥品占比大概超過六成，這代表什麼？代表我們的國產比例是紙面數據，實際上架的藥在10包裡面有6包是進口的。我想請問一下，有多少藥品是真的在臺灣生產？說明占比就好。"],["姜署長至剛：這邊跟委員做報告，的確我們現在原料藥在應用的部分，以中國跟印度的占比相當、相當高，分別是27%及26%，所以在這種情形之下，我們原料藥的依存度是的確是非常、非常高的……"],["邱委員鎮軍：我們必要藥品清單上有大概584項，有多少是在臺灣生產？"],["姜署長至剛：這部分我可能要精確的確認一下正確的數字。"],["邱委員鎮軍：你們是主管機關，這個必須要確實掌握，因為我認為現在是全球在重新洗牌，這個供應鏈全部在重新洗牌，所以你們這些都應該要確實掌握。因為這個任何一個主要的來源國出問題，我們的醫療系統就會出現缺口，對不對？"],["邱部長泰源：對。"],["邱委員鎮軍：所以我看到剛剛你講的，如果成本反應到藥價上是健保吸收，還是我們人民吸收？"],["邱部長泰源：因為我們的健保是單一的保險機構……"],["邱委員鎮軍：我這樣講，我問了那麼多，你們都好像搞不太清楚狀況，因為你們是藥品的主要主管機關，所有藥品的製造、輸入、販賣都必須登錄在藥品許可證資料庫，這個資料庫是你們的職責嘛，對不對？照理說，你們應該隨時都可以查出來，我不希望這個東西到後來變成一個……萬一真的發生了，你們要怎麼去面對這個問題，這個才是我比較擔心的。"],["邱部長泰源：第一個，我們絕對會盡力不要增加人民就醫的負擔，包括藥價的負擔，所以我們很早就做好各種準備，不管是美國關稅的變化，我們有強化供應的預警，一定不能讓它缺藥。"],["邱委員鎮軍：我有看到你們缺藥平臺有在做，可是你們的缺藥平臺等它已經有這個數據顯現出來的時候，就是已經發生的事情，對不對？"],["邱部長泰源：我要求……"],["邱委員鎮軍：我要的是你們在更早之前能夠確實掌握這個藥品的數量。"],["姜署長至剛：謝謝委員的提點。因為針對預警的平臺，我們是西藥劑、醫藥器材的供應短缺平臺"],["邱委員鎮軍：對。"],["姜署長至剛：關於平臺的登錄，其實我們在藥事法裡就已經規定製劑是半年內就必須提出來，所以在提前的時間內，在還沒有缺藥之前。另外補充一下，剛提到製劑的部分，我們國產的製劑其實占了73.64%，是屬於國產的；我們化學藥品的部分其實是95.09%……"],["邱委員鎮軍：原料藥呢？"],["姜署長至剛：原料藥的部分相對是比較低，目前的占比只有接近15%左右，所以這部分是我們持續在努力的一個地方。"],["邱委員鎮軍：好啦！我跟你講，剛剛講這些，我希望你們能夠確實掌握。另外，當然缺藥平臺也很重要，可是我認為你們內部應該有一個提早預警的機制，不能夠等這個數字顯示出來的時候，才再來處理。再來，剛剛講到你們現在有在扶植本土藥廠，對吧！當然就多了一層保障，但是我們可能馬上面臨的問題，我們比較擔心的是我們的患者會不會受到影響？因為你們現在才要扶植嘛！他們並不會那麼快啊，對不對？"],["石署長崇良：跟委員報告，剛剛提到的我們整個健保額給付的藥品品項大概一萬四千多種啦！這裡面就如同剛剛提到的，70%的量等於是學名藥或者是在臺灣製造，另外的30%是靠進口。而在進口裡我們最需要掌握的就是在專利期內的，因為這個就算去扶植都沒有用，因為它是專利保護，專利保護的品項大概是214項，金額大概在390億左右。而這裡面還有一些是沒有辦法替代及品項很少的，這個大概在275項，金額大概在200億左右，所以我們才會編列特別預算，爭取特別預算以因應未來在專利期內的這些藥。"],["邱委員鎮軍：所以就是6到18個月嘛，對不對？"],["石署長崇良：對。"],["邱委員鎮軍：一樣是健保去吸收成本嗎？這樣的話，健保會不會到時候的壓力又越來越大？你們在什麼情況下，會再做調整？"],["石署長崇良：當然我們目前有在行政院因應國際情勢特別條例的特別預算裡，是有編列給健保200億的健保基金來因應這樣的變局啦！但是長期來講，當然也會造成健保保費的壓力，確實是這樣。"],["邱委員鎮軍：對，你現在講的是健保，萬一是自費的部分呢？自費的藥品呢？這些部分的成長，你們有掌握嗎？"],["石署長崇良：關於自費的，我們就沒有這樣的資料。"],["邱委員鎮軍：沒有資料？萬一國人生病怎麼辦？"],["姜署長至剛：這邊跟委員也進一步說明，剛剛也有特別提到我們的藥品自製國產的部分，因為國內的市場相對比較小，所以有時候供應其實是供需上面需要有很好的調控，我們特別把所謂希望做智慧監控的導入在未來我們藥事法第二十七條之三的修法上面，也希望我們的藥品在有短缺的情況之下，都進入我們能夠調控的一個機制之內，未來也需要委員給予我們很多的支持，以上說明。"],["邱委員鎮軍：好啦！不管是健保藥品或者是自費的藥品，我希望你們衛福部都要確實掌握啦！因為這些都關乎我們國人的健康，臺灣不只藥變貴，我是這樣看，我更擔心是這個藥買不到，更是重點。我希望大家能夠把這個螺絲拴緊，好不好？"],["邱部長泰源：沒問題。"],["邱委員鎮軍：再來，我請教部長的就是PM2.5直接影響疾病負擔，死亡統計與健保支出，這是不是衛福部的業務？有嗎？"],["邱部長泰源：PM2.5？"],["邱委員鎮軍：就是PM2.5的死亡統計跟健保的支出。世界衛生組織2019年統計很清楚，PM2.5造成的過早死亡有將近七成是心臟病與中風、14%是慢性阻塞性肺病、14%是肺炎，另外4%是肺癌。所以我先問這個部分是你們衛福部的核心公共衛生問題嗎？"],["邱部長泰源：我想不管任何的因素影響到健康都是我們衛福部應該要去關心的。"],["邱委員鎮軍：你們有數據嗎？"],["邱部長泰源：哪一方面的數據？"],["邱委員鎮軍：你們有針對這個部分做過調查嗎？"],["邱部長泰源：各方面影響健康，我想相關的期刊特別多，但是我們要看期刊……"],["邱委員鎮軍：在2023年國際的Science期刊的研究，第一次把PM2.5按照來源分類，發現燃煤火力發電的PM2.5致死風險是其他來源的2.1倍，美國因此每年多死了4萬3,000人，20年間累積了46萬人，這代表在所有這些致命的疾病背後，有相當比例的風險來自於燃煤這種加倍致命的污染源。部長，我請問你，有沒有針對燃煤的PM2.5做過全國的健康衝擊評估？有沒有做？"],["邱部長泰源：過去我也在這邊當過8年的立委，幾乎都是在質詢這個問題……"],["邱委員鎮軍：所以你應該很了解吧！"],["邱部長泰源：當然這個跟環境部、跟衛福部都有相關……"],["邱委員鎮軍：當然，這是跨部會的，但是你們……"],["邱部長泰源：這一個部分，因為空污的狀況或PM2.5這個部分，我們要看看它的來源，來分析……"],["邱委員鎮軍：對啊！別人都有在做，他們分類都分得很清楚，你們有沒有做嘛！"],["邱部長泰源：分析來源以外，第二個就是要科學的分析，科學的分析就是要有足夠的證據力……"],["邱委員鎮軍：對啊！結果你有做嗎？你有做嗎？"],["邱部長泰源：我們也不能拿一、二篇paper就來說……"],["邱委員鎮軍：不是，我現在就是請教你，你們有沒有做？就是沒有，對不對？"],["邱部長泰源：我們來了解，國衛院現在應該有相關的……"],["邱委員鎮軍：我不希望這樣，你說國衛院有做，那衛福部不是要掌握嗎？這個不是關乎國人的健康嗎？"],["邱部長泰源：我們當然是很關心國人的健康……"],["邱委員鎮軍：對不對？所以我認為你的立場和環境部的立場，必須要以國人的健康作為出發，來去做提點，不管未來他們要怎麼去施政，或者政策方向怎麼走，至少你們要盡到衛福部應有的職責，我這樣講沒錯吧！"],["邱部長泰源：對，我想空污跟各種疾病的相連性有強弱之別，我們都會去看看國內外的文獻，來做好政策的分析，一定要儘量減少對民眾的影響，這個部分是我們基本要去做的事情。"],["邱委員鎮軍：好啦！我是希望衛福部盡到自己業務的職責，不要讓臺灣人用肺發電，尤其中火，就已經占了一半以上，所以這個部分真的是非常非常嚴重！請主管機關不要當作沒事一樣，要勇於挑戰，因為上面的政策怎麼樣是一回事，你們的業務是你的責任，應該說清楚的，我還是希望大家說清楚，好不好？"],["邱部長泰源：對，我們會按照科學的根據，有科學的根據來……"],["邱委員鎮軍：好啦！最好是這樣，不要變成幫能源政策化妝，好不好？我講的重點在這裡。"],["邱部長泰源：我們會站在人民的健康立場來分析……"],["邱委員鎮軍：好，謝謝部長。"],["邱部長泰源：謝謝。"],["主席：謝謝邱委員，還有謝謝部長。再來請王育敏委員質詢，王育敏委員質詢完畢，休息10分鐘。"]],"agenda":{"page_end":328,"meet_id":"委員會-11-3-26-24","speakers":["蘇清泉","陳昭姿","林月琴","陳菁徽","邱鎮軍","王育敏","廖偉翔","盧縣一","林淑芬","黃秀芳","王正旭","葉元之","陳瑩","劉建國","楊曜","涂權吉"],"page_start":267,"meetingDate":["2025-08-14"],"gazette_id":"1147202","agenda_lcidc_ids":["1147202_00007"],"meet_name":"立法院第11屆第3會期社會福利及衛生環境委員會第24次全體委員會議紀錄","content":"邀請衛生福利部、經濟部、財政部就「美國針對進口藥品、原料藥課稅對我國產業造成影響」進\n行專題報告，並備質詢","agenda_id":"1147202_00006"}}}