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{\"word\": \"功\", \"start\": 762.072, \"end\": 762.212, \"score\": 0.992}, {\"word\": \"能\", \"start\": 762.212, \"end\": 762.412, \"score\": 0.906}, {\"word\": \"性\", \"start\": 762.412, \"end\": 762.612, \"score\": 0.996}, {\"word\": \"嘛\", \"start\": 762.612, \"end\": 763.692, \"score\": 0.948}, {\"word\": \"對\"}, {\"word\": \"照\", \"start\": 763.692, \"end\": 763.712, \"score\": 0.013}, {\"word\": \"韓\"}, {\"word\": \"國\"}]}, {\"start\": 765.117, \"end\": 779.593, \"text\": \"人家一個國家級的一個癌症這個中心可以創造出這麼大的一個成績的效果出來降低他們癌症的死亡率降低他們致癌的這樣一個比例然後包含開發了這麼多的一個新藥\", \"words\": [{\"word\": \"人\", \"start\": 765.117, \"end\": 765.217, \"score\": 0.934}, {\"word\": \"家\", \"start\": 765.217, \"end\": 765.337, \"score\": 0.969}, {\"word\": \"一\", \"start\": 765.337, \"end\": 765.798, \"score\": 0.912}, {\"word\": \"個\"}, {\"word\": \"國\"}, {\"word\": \"家\", \"start\": 765.798, \"end\": 766.258, \"score\": 0.953}, {\"word\": \"級\"}, {\"word\": \"的\", \"start\": 766.258, \"end\": 766.398, \"score\": 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{\"word\": \"亡\", \"start\": 774.928, \"end\": 775.088, \"score\": 1.0}, {\"word\": \"率\", \"start\": 775.088, \"end\": 775.509, \"score\": 0.952}, {\"word\": \"降\", \"start\": 775.509, \"end\": 775.709, \"score\": 0.999}, {\"word\": \"低\", \"start\": 775.709, \"end\": 775.809, \"score\": 0.86}, {\"word\": \"他\", \"start\": 775.809, \"end\": 776.089, \"score\": 0.867}, {\"word\": \"們\"}, {\"word\": \"致\", \"start\": 776.089, \"end\": 776.21, \"score\": 0.835}, {\"word\": \"癌\", \"start\": 776.21, \"end\": 776.35, \"score\": 0.858}, {\"word\": \"的\", \"start\": 776.35, \"end\": 776.45, \"score\": 0.989}, {\"word\": \"這\"}, {\"word\": \"樣\"}, {\"word\": \"一\", \"start\": 776.45, \"end\": 776.79, \"score\": 0.873}, {\"word\": \"個\"}, {\"word\": \"比\", \"start\": 776.79, \"end\": 776.93, \"score\": 0.879}, {\"word\": \"例\", \"start\": 776.93, \"end\": 778.072, \"score\": 0.992}, {\"word\": \"然\", \"start\": 778.072, \"end\": 778.192, \"score\": 0.833}, {\"word\": \"後\", \"start\": 778.192, 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1130.496, \"end\": 1130.976, \"score\": 0.885}, {\"word\": \"謝\"}, {\"word\": \"謝\"}, {\"word\": \"了\", \"start\": 1130.976, \"end\": 1131.276, \"score\": 0.913}, {\"word\": \"謝\"}, {\"word\": \"謝\"}, {\"word\": \"部\", \"start\": 1131.276, \"end\": 1131.396, \"score\": 0.831}, {\"word\": \"長\"}, {\"word\": \"謝\"}, {\"word\": \"謝\"}, {\"word\": \"署\", \"start\": 1131.396, \"end\": 1131.757, \"score\": 0.879}, {\"word\": \"長\"}, {\"word\": \"主\", \"start\": 1131.757, \"end\": 1131.857, \"score\": 0.797}, {\"word\": \"席\", \"start\": 1131.857, \"end\": 1131.877, \"score\": 0.0}, {\"word\": \"請\"}, {\"word\": \"站\", \"start\": 1131.877, \"end\": 1131.897, \"score\": 0.001}, {\"word\": \"起\", \"start\": 1131.897, \"end\": 1131.917, \"score\": 0.0}, {\"word\": \"來\"}, {\"word\": \"謝\"}, {\"word\": \"謝\"}, {\"word\": \"謝\"}, {\"word\": \"謝\"}, {\"word\": \"你\", \"start\": 1135.202, \"end\": 1135.323, \"score\": 0.827}, {\"word\": \"講\"}, {\"word\": \"了\", \"start\": 1135.323, \"end\": 1135.464, \"score\": 0.839}, {\"word\": \"十\", \"start\": 1135.464, \"end\": 1136.413, \"score\": 0.978}, {\"word\": \"分\", \"start\": 1136.413, \"end\": 1136.454, \"score\": 0.499}, {\"word\": \"鐘\"}, {\"word\": \"啊\", \"start\": 1136.454, \"end\": 1136.474, \"score\": 0.0}], \"language\": \"zh\"}","srt":"1\n00:00:10,166 --> 00:00:36,016\n趙偉辛苦請坐有請部長部長美國總統川普8月5號我沒有問你認不認識不要誤會8月5號的時候在接受媒體採訪的時候有公開表示會先對藥品課一個小關稅但一年到一年半之間稅率將提高到150%然後會再提高到250%\n\n2\n00:00:37,897 --> 00:01:02,566\n因此他希望藥品要在他們美國國內生產這個川普大帝隨便講一句話即便還沒有發生都還沒有發生就會造成全球大混亂因為他這句話果不其然全球的藥廠開始緊張所以因此趙偉今天再排一次我4月7日已經排過一次了你看趙偉多用心然後也緊張這個事情所以再排這一次的專報\n\n3\n00:01:03,886 --> 00:01:24,242\n邀請大家一起在這些討論所以我針對這個議題我特別在關心因為在11本月11日的時候又有一篇報導部長請看一下是大家上去說藥廠為了維持利潤可能會把這個成本轉嫁到其他國家全球藥價都會飆漲漲幅恐怕超過兩成那有癌症病友就透露\n\n4\n00:01:25,003 --> 00:01:33,738\n大家現在很焦慮因為光是一年的智慧藥物就百萬起跳如果藥價再漲半年可能就要多花五十萬恐怕人與戶惡\n\n5\n00:01:35,973 --> 00:02:02,530\n然後癌藥的三大優略裡面部長再看一下已經智慧用藥的癌藥若藥價再持續上漲那癌藥恐怕就難以負擔那第二若癌藥漲價目前已經在健保幾戶中的癌藥會不會有重新溢價或退出的問題那第三對可能準備納入健保的癌藥會不會因為這波的關稅衝擊最終變成無法納入部長有掌握嗎\n\n6\n00:02:05,679 --> 00:02:33,440\n謝謝召委的關心這的確是我們政府應該努力的我們現在追求癌症的死亡率標準死亡率在2030年要降低三分之一怎麼樣給病人最好的一個早期的篩檢然後適當的精準的一個基因檢測然後精準的治療其實是很需要藥物的我們政府尤其衛護部這邊一定全力\n\n7\n00:02:34,221 --> 00:02:58,996\n不管是在健保或智慧的支付方面一定不要去增加癌友的一個負擔這是一個最大的原則一定不要去增加癌友的負擔面對到關稅的衝擊哪怕調到150到250就是不能讓癌友增加這些藥物的費用的負擔嘛對不對我想我們一定要以這樣來做最大的原則OK好謝謝有些做法讓時事長知道\n\n8\n00:03:04,178 --> 00:03:20,893\n這個衝擊真的是蠻大的那未來到底會走到什麼程度我們會密切的注意不過我們盤點那麼因應如果這個全球的這些藥價都一起漲的時候那麼我們最大的衝擊會是在於還在專利期內的藥就是我們\n\n9\n00:03:22,254 --> 00:03:44,659\n其他都還有溢價空間可是專利期內的藥通常它的那個寡占性比較強所以我們首先先盤點這個在專利期內的藥還有多少項以健保來講還有214項左右是屬於專利期的藥專利期內的藥大概一年的現在健保的支出大概在390億左右\n\n10\n00:03:45,279 --> 00:04:13,295\n那這裡面呢如果又是把它屬於基本就是必要藥品的那大概是在75項左右那麼大概是200億啦所以我們在短期內呢當然會需要多一點這個費用來挹注因應這個萬一調漲的時候我們比較沒有那個溢價空間就只好要多付出一些啦那第二個呢是這些專利\n\n11\n00:04:14,275 --> 00:04:37,034\n的藥呢在未來五六年內大概有76個品項他會過專利期所以我們要鼓勵這個趕快這個過專利期的趕快有這個學名藥或生物相似藥來遞汰他的藥價就會比較低所以我們也有一個鼓勵的措施就是如果你在這個專利期一過的五年內來提出的這個\n\n12\n00:04:38,775 --> 00:05:04,487\n这个学名药或者是生物相似药前两张我们价格让它跟原厂一样来分散这个用药的风险这个是第二个那当然第三个就是学名药的鼓励这里面还是有很多会是学名药所以我们也鼓励学名药我们去年先从生物相似药开始那今年我们就鼓励癌症的化学药\n\n13\n00:05:05,327 --> 00:05:30,765\n那麼學名藥我們也鼓勵也有這個獎勵的措施明年我們開始會把所有的癌症的用藥的學名藥也都納入我們獎勵所以我們這樣一步一步來因應好我時間很足夠讓署長一一做這樣的說明對不對所以你已經占了我的質詢一半的時間請主席要補回來給我但是言而總之總而言之就是我聽部長那句話\n\n14\n00:05:31,906 --> 00:05:48,271\n不管美國的關稅如何調整對藥價的關稅如何調整總而言之言而總之就不能讓我們的癌友因為關稅的調整造成他更大的負擔我就是聽這句話但是這還是要有相關的一些因應作用跟配套簡單講不管150還是250衛生部應該盡速針對癌症寒病重症這三類別提出藥品別\n\n15\n00:05:59,155 --> 00:06:12,868\n這個治療線別還有病類別可能受到這個衝擊評估及領域調查我想這個應該要做吧好這個一直有在做但是因為川普一直變化我們也會隨之他來調整OK\n\n16\n00:06:14,403 --> 00:06:27,591\n這個如果有必要的話隨時可以做相關的報告好因為川普一直在變化所以你們也是做相關的一些調查也是要跟著變動這個我很清楚但是我這邊可以再跟部長建議一下主動監控這些\n\n17\n00:06:29,765 --> 00:06:46,973\n這些藥品就是跟特別講的癌症含病重症的他的這個智慧藥品的價格波動緊密的追蹤國內藥品價格是我受到國際因素的提高並隨時提出相關的因素措施避免市長這個訊息不對稱造成恐慌性的加價這可以吧\n\n18\n00:06:49,233 --> 00:07:00,252\n當然這應該要這樣做你要這樣做你沒有這樣做嗎你沒有隨著川普的變動做這樣一個市場執行的監控嗎應該沒有吧那個食藥署要不要回答一下\n\n19\n00:07:03,171 --> 00:07:19,177\n不好意思要用你的時間好已經超過四分之三了這個主席會補給我對藥品的監控的話我們在於我們的製劑要兩個到三個月如果在半年前製劑已經有短缺的在通報系統上面通報我們啟動整個藥學會的評估\n\n20\n00:07:21,118 --> 00:07:46,858\n必要之時我們可以做專案的進口跟專案的輸入以及做藥品的調控那接下來其實是更進一步在藥事法二十七之三條所有不見得是在必要藥品在所有藥品的短缺的情況之下需要有一個進入調配的機制政府能夠進一步的介入那這個部分是我們目前是希望能夠智慧導入的不是我是所長我請教部長的是針對價格的部分\n\n21\n00:07:47,979 --> 00:08:11,946\n你是在回應我是針對到時候我缺這些藥品的時候可以從怎樣來輸入嘛對不對我是針對這個價格的部分啦我想因為自費藥品的價格部分在食藥署其實我們這邊沒有特別的定價的這個的一個的一個權責在裡面我們這些其實是針對所以你意思是部長找你上來打呼我就不對了嘛他找錯人了自費其實是好\n\n22\n00:08:16,927 --> 00:08:35,670\n我想智慧的藥品也是對這些集中重症和寒病的病人很大的負擔所以這個一定要我們站在政府的立場一定要監測而且不能讓他隨意負擔增加我想這個部分所以請大家不要也請藥廠不能\n\n23\n00:08:36,471 --> 00:08:52,567\n不能隨便加價也不要有恐慌的加價的現象好那就請部長跟委員會做一個說明你們的監測機制應該就是在因應這個美國關稅過程裡面馬上就啟動嘛然後適時的再去公布這些相關的訊息嘛好我們馬上啟動OK好謝謝價格的一個波動\n\n24\n00:08:55,169 --> 00:09:16,320\n謝謝好第二個題目剛剛部長有答覆我嘛我們要追求到2031年把這個癌症致死率降到這個三分之一嘛對不對降至三分之一嘛但是從長遠來看我覺得台灣必定要盡速扶持國家的生技產業啦這個部分絕對不是衛部這是跨部會包含經濟部等等等包含國華會嘛\n\n25\n00:09:17,681 --> 00:09:35,411\n我想現在要去鼓勵外國的大型的藥廠來台灣投資設廠我看也困難了啦因為美國是希望到他們的國家去設嘛才免除這個關稅的問題嘛但是相對的我們不用去鼓勵國外的來設廠那國內的可能你要大肆的來做\n\n26\n00:09:36,511 --> 00:09:51,864\n相關的一些獎勵或是鼓勵的措施讓我們降低對國外的這些藥廠的依賴我為什麼這麼講其實衛福部應該不只是可以扶持民間的藥廠我們還有相關的一些能力可以做整合\n\n27\n00:09:53,131 --> 00:10:15,641\n對不對投入開發都可以做我要以韓國為例韓國在2000年成立國家癌症中心不僅整合國內的癌症各項業務也包含臨床的治療研究等項目最重要最重要的是他本身也有研發癌症藥物的能力他們已經自主研發多項抗癌先藥涵蓋免疫療法標靶藥以及能量代謝抑制劑\n\n28\n00:10:17,314 --> 00:10:32,150\n然後從南海的媒體數據資料也看出南海癌症的整體死亡率2002年到2013年年年均下降到2.8%然後2013到2021是最近的已經下降到3.2%同時我再一個資料\n\n29\n00:10:35,990 --> 00:11:02,155\n那個資料沒有把我顯示出來嗎你生病了嗎同時對比台灣年齡標準化的這個癌症的死亡率2024年台灣每10萬人就有大約113人死於癌症南韓大約是61人他不到我們一半喔差不多一半啦差不多一半如果按照南韓的人口數對比起來少之又少\n\n30\n00:11:03,394 --> 00:11:24,099\n少之又少那天下雜誌在2022年又有一個專題報告就是韓國做了什麼20年前做了一個決定如今罹癌率死亡率都比台灣低開頭就講韓國的癌症發生率死亡率都低於台日五年存活率更高達78背後關鍵就是在2000年成立國家癌症中心\n\n31\n00:11:25,589 --> 00:11:50,601\n這是天下大事的一個報導給部長做參考也就是說有資源有預算還有整個政策的這個支持人家的成果就是如此他們的國營也不用在那邊擔心藥價會不會漲太過擔憂那如果對照台灣我們現在只有行政院的中央癌症防治匯報還有國衛院的癌症研究所\n\n32\n00:11:51,687 --> 00:12:13,163\n對不對是好部長你知道你有參與這個行政院的中央癌症紅字會報嗎有啊有嘛那一年開幾次會應該至少每半年開一次會有嗎有有有我們都有去參加應該是沒有吧我的資料裡面是111年到113年這三年就只有在12月開一次會\n\n33\n00:12:22,560 --> 00:12:43,712\n主責當然是國健署跟健保署嘛再加上國衛院轄下的癌症研究所因為在場應該有國健跟健保署嘛可以問一下這三年是不是都12月才開一次會我要跟部長提醒的啦不是開會幾次的重要性與否啦是這個功能性嘛對照韓國\n\n34\n00:12:45,117 --> 00:12:59,593\n人家一個國家級的一個癌症這個中心可以創造出這麼大的一個成績的效果出來降低他們癌症的死亡率降低他們致癌的這樣一個比例然後包含開發了這麼多的一個新藥\n\n35\n00:13:01,189 --> 00:13:19,765\n它幾乎是一個國家級的一個癌症中心它給予所有的功能於一切啦所以才有辦法去打造那個降低死亡率的目標我們要配合賴總統的健康台灣我們到2023年要降低癌症死亡率三分之一我們不能沒有積極的作為啊\n\n36\n00:13:20,680 --> 00:13:42,899\n一定要更多一些機器的作為嘛那我是拿韓國的例子可以做參考部長當然還是可以其他參照其他國家嘛那如果韓國的案子可以參考是不是趕快來做一些相關研究然後一個月內給委員會做一個報告那我們知道說我們要如何在2031年可以降低癌症的死亡率達到三分之一\n\n37\n00:13:43,379 --> 00:13:58,768\n好的可以吧我們大概三支箭嘛第一個是癌症早期篩檢請大家民眾篩檢這個我知道現在的篩檢也擴大了也增加了40億第二個就是癌症的基因檢測以做精準的一個治療然後\n\n38\n00:14:00,009 --> 00:14:26,967\n我看我們健保室每天都在公布又有什麼癌藥進來進來所以其實今年進了很多很多的癌藥對於醫師來講在治療上面真的多了很多的力氣這個大概都會都一定可以降低我們的一個五年的提升五年存活力那這個部分如果是不是說現在台灣是這樣各個醫院都已經這麼大間去那裡因為白龍有綜藝職\n\n39\n00:14:29,469 --> 00:14:52,066\n台大他現在資質運作電子機也資質運作所以在台灣也許要用我們這樣的一個情況我們怎麼樣集合大家的力量是用什麼方式這的確是可以正如委員所講的來思考但是協調整合這個是一定\n\n40\n00:14:53,027 --> 00:15:20,262\n都有其實也一直這幾十年也一直有在做我知道你們都有在做但是我只是用韓國例子來講它是2000年就要比我們在講長照日本的健康保險也是2000年開始那台灣在2000年跟2025年之間我們對防癌降低癌症死亡率都有在做這個署長也都是很記在做但是我只是講說用一個韓國例子來跟你做參考其他有其他國家的例子也都可以讓部長參考\n\n41\n00:15:21,263 --> 00:15:33,585\n我們要如何在這三事件已經發動的時候短短短的時間2030年現在經濟恐慌出沒四年多不是出五年出沒四年多我們要去降到三分之一\n\n42\n00:15:35,212 --> 00:15:57,410\n我們會有很大很大的挑戰啊還等到川普大帝會不會這樣會不會這樣那個藥劑我們要去因應因應嘛那剛剛聽部長講那時候我當然替這些癌友感到窩心嘛感到溫暖嘛最起碼不能再造成他們增加這些癌症新藥的癌症藥物的一些負擔嘛不管關稅如何去做調整嘛\n\n43\n00:15:58,130 --> 00:16:21,812\n其實部長講這些話坦白講就已足夠了啦但是我們還是期待說可以達到2030年這樣的一個目標所以我才會擔憂才會用韓國的例子來給部長做參考給署長做參考我們來瞭解韓國他的做法然後跟我們現在台灣怎麼做也許是有什麼我們來做一個比較再跟委員報告分析好最後這個是召委多給我的時間我再講一下因為跟屏東有關係所以要講一下\n\n44\n00:16:22,552 --> 00:16:44,602\n昨天又有颱風再度掃過這個我們受災嚴重中南部嘛在風災之後登革熱就是異化的時間點我想這個大家都知道那中國現在又爆發這個屈公病那屈公病又跟這個登革熱一樣都是透過這個埃及斑蚊還有白腺斑蚊的傳染的疾病這民眾會恐慌啦那部長應該還記得2023年那時候是薛部長他為了這個事情還到雲林應該有兩趟因為那個時候\n\n45\n00:16:50,164 --> 00:17:10,275\n是從2015年來爆發最嚴重的一次將近本土確診病例登革熱的這樣的一個對象高達兩萬人左右當時嚴重到必須要封閉農民的果園消毒也造成農民在整個嚴重的經濟損失所以那一年我才跟這個\n\n46\n00:17:11,915 --> 00:17:23,789\n當地的林鄉長還有在地的一些民代跑到行政院來跟行政院做一些緩令最後行政院核定了一千八百多萬的登革熱傳染病溶損補助\n\n47\n00:17:25,356 --> 00:17:49,872\n這也算是破紀錄啦因為整個都封起來了農民沒有辦法沒有辦法去守恆嘛沒有辦法去採收嘛對不對沒有辦法去補肥嘛沒有辦法去噴農藥嘛因為將農藥回到野外就比農藥還差一筒啊所以那組成農民的經濟損失嘛不才會去啟動來做這個步驟嘛我覺得是說因為鳳梯丹南市丹南零七二八現在還洋流\n\n48\n00:17:50,872 --> 00:18:10,420\n這個事後可能在很快的很短的時間內會不會造成這個登革熱還有這個區公併的區公併當然也是境外的一個防堵嘛那登革熱是有可能本土的又再起所以可能要未雨綢繆如果不積極的趕快去做相關的一些因應那到時候政府又要投入很大的人力物力甚至預算\n\n49\n00:18:11,365 --> 00:18:25,644\n所以請部長一個星期內可能一個星期還太久我覺得因為洋流已經過了嘛所以我們從風災來之前都一直在做宣導\n\n50\n00:18:26,385 --> 00:18:51,917\n同時也督導地方的衛生局在環境的清潔上面特別要注意到登革熱的相關的疫苗的一個預防那也氣功病其實也是沒有人傳播他也不會人傳染所以是一樣的啦也是要清到循道清刷一樣去把它落實啦希望就不要避免到對人民更進一步的傷害好謝謝了謝謝部長謝謝署長主席請站起來謝謝\n\n51\n00:18:55,202 --> 00:18:56,474\n謝謝你講了十分鐘啊\n\n","tsv":"start\tend\ttext\n10166\t36016\t趙偉辛苦請坐有請部長部長美國總統川普8月5號我沒有問你認不認識不要誤會8月5號的時候在接受媒體採訪的時候有公開表示會先對藥品課一個小關稅但一年到一年半之間稅率將提高到150%然後會再提高到250%\n37897\t62566\t因此他希望藥品要在他們美國國內生產這個川普大帝隨便講一句話即便還沒有發生都還沒有發生就會造成全球大混亂因為他這句話果不其然全球的藥廠開始緊張所以因此趙偉今天再排一次我4月7日已經排過一次了你看趙偉多用心然後也緊張這個事情所以再排這一次的專報\n63886\t84242\t邀請大家一起在這些討論所以我針對這個議題我特別在關心因為在11本月11日的時候又有一篇報導部長請看一下是大家上去說藥廠為了維持利潤可能會把這個成本轉嫁到其他國家全球藥價都會飆漲漲幅恐怕超過兩成那有癌症病友就透露\n85003\t93738\t大家現在很焦慮因為光是一年的智慧藥物就百萬起跳如果藥價再漲半年可能就要多花五十萬恐怕人與戶惡\n95973\t122530\t然後 癌藥的三大優略裡面 部長再看一下已經智慧用藥的癌藥 若藥價再持續上漲那癌藥恐怕就難以負擔那第二 若癌藥漲價目前已經在健保幾戶中的癌藥會不會有重新溢價或退出的問題那第三 對可能準備納入健保的癌藥會不會因為這波的關稅衝擊 最終變成無法納入部長有掌握嗎\n125679\t153440\t謝謝召委的關心這的確是我們政府應該努力的我們現在追求癌症的死亡率標準死亡率在2030年要降低三分之一怎麼樣給病人最好的一個早期的篩檢然後適當的精準的一個基因檢測然後精準的治療其實是很需要藥物的我們政府尤其衛護部這邊一定全力\n154221\t178996\t不管是在健保或智慧的支付方面一定不要去增加癌友的一個負擔這是一個最大的原則一定不要去增加癌友的負擔面對到關稅的衝擊哪怕調到150到250就是不能讓癌友增加這些藥物的費用的負擔嘛 對不對我想我們一定要以這樣來做最大的原則OK 好 謝謝有些做法讓時事長知道\n184178\t200893\t這個衝擊真的是蠻大的那未來到底會走到什麼程度我們會密切的注意不過我們盤點那麼因應如果這個全球的這些藥價都一起漲的時候那麼我們最大的衝擊會是在於還在專利期內的藥就是我們\n202254\t224659\t其他都還有溢價空間可是專利期內的藥通常它的那個寡占性比較強所以我們首先先盤點這個在專利期內的藥還有多少項以健保來講還有214項左右是屬於專利期的藥專利期內的藥大概一年的現在健保的支出大概在390億左右\n225279\t253295\t那這裡面呢如果又是把它屬於基本就是必要藥品的那大概是在75項左右那麼大概是200億啦所以我們在短期內呢當然會需要多一點這個費用來挹注因應這個萬一調漲的時候我們比較沒有那個溢價空間就只好要多付出一些啦那第二個呢是這些專利\n254275\t277034\t的藥呢在未來五六年內大概有76個品項他會過專利期所以我們要鼓勵這個趕快這個過專利期的趕快有這個學名藥或生物相似藥來遞汰他的藥價就會比較低所以我們也有一個鼓勵的措施就是如果你在這個專利期一過的五年內來提出的這個\n278775\t304487\t这个学名药或者是生物相似药前两张我们价格让它跟原厂一样来分散这个用药的风险这个是第二个那当然第三个就是学名药的鼓励这里面还是有很多会是学名药所以我们也鼓励学名药我们去年先从生物相似药开始那今年我们就鼓励癌症的化学药\n305327\t330765\t那麼學名藥我們也鼓勵也有這個獎勵的措施明年我們開始會把所有的癌症的用藥的學名藥也都納入我們獎勵所以我們這樣一步一步來因應好 我時間很足夠讓署長一一做這樣的說明 對不對所以你已經占了我的質詢一半的時間請主席要補回來給我但是言而總之 總而言之就是我聽部長那句話\n331906\t348271\t不管美國的關稅如何調整 對藥價的關稅如何調整總而言之 言而總之就不能讓我們的癌友因為關稅的調整造成他更大的負擔我就是聽這句話但是這還是要有相關的一些因應作用跟配套簡單講 不管150還是250 衛生部應該盡速針對癌症 寒病重症這三類別 提出藥品別\n359155\t372868\t這個治療線別還有病類別可能受到這個衝擊評估及領域調查我想這個應該要做吧好 這個一直有在做但是因為川普一直變化我們也會隨之他來調整OK\n374403\t387591\t這個如果有必要的話隨時可以做相關的報告好 因為川普一直在變化所以你們也是做相關的一些調查也是要跟著變動 這個我很清楚但是我這邊可以再跟部長建議一下主動監控這些\n389765\t406973\t這些藥品就是跟特別講的癌症含病重症的他的這個智慧藥品的價格波動緊密的追蹤國內藥品價格是我受到國際因素的提高並隨時提出相關的因素措施避免市長這個訊息不對稱造成恐慌性的加價這可以吧\n409233\t420252\t當然 這應該要這樣做你要這樣做 你沒有這樣做嗎你沒有隨著川普的變動做這樣一個市場執行的監控嗎應該沒有吧那個食藥署要不要回答一下\n423171\t439177\t不好意思 要用你的時間好 已經超過四分之三了這個主席會補給我對藥品的監控的話我們在於我們的製劑要兩個到三個月如果在半年前製劑已經有短缺的在通報系統上面通報我們啟動整個藥學會的評估\n441118\t466858\t必要之時我們可以做專案的進口跟專案的輸入以及做藥品的調控那接下來其實是更進一步在藥事法二十七之三條所有不見得是在必要藥品在所有藥品的短缺的情況之下需要有一個進入調配的機制政府能夠進一步的介入那這個部分是我們目前是希望能夠智慧導入的不是 我是所長我請教部長的是針對價格的部分\n467979\t491946\t你是在回應我是針對到時候我缺這些藥品的時候可以從怎樣來輸入嘛對不對我是針對這個價格的部分啦我想因為自費藥品的價格部分在食藥署其實我們這邊沒有特別的定價的這個的一個的一個權責在裡面我們這些其實是針對所以你意思是部長找你上來打呼我就不對了嘛他找錯人了自費其實是好\n496927\t515670\t我想智慧的藥品也是對這些集中重症和寒病的病人很大的負擔所以這個一定要我們站在政府的立場一定要監測而且不能讓他隨意負擔增加我想這個部分所以請大家不要也請藥廠不能\n516471\t532567\t不能隨便加價也不要有恐慌的加價的現象好 那就請部長跟委員會做一個說明你們的監測機制應該就是在因應這個美國關稅過程裡面馬上就啟動嘛然後適時的再去公布這些相關的訊息嘛好 我們馬上啟動OK 好 謝謝價格的一個波動\n535169\t556320\t謝謝 好 第二個題目剛剛部長有答覆我嘛我們要追求到2031年把這個癌症致死率降到這個三分之一嘛 對不對降至三分之一嘛但是從長遠來看 我覺得台灣必定要盡速扶持國家的生技產業啦這個部分絕對不是衛部 這是跨部會包含經濟部等等等 包含國華會嘛\n557681\t575411\t我想現在要去鼓勵外國的大型的藥廠來台灣投資設廠我看也困難了啦因為美國是希望到他們的國家去設嘛才免除這個關稅的問題嘛但是相對的我們不用去鼓勵國外的來設廠那國內的可能你要大肆的來做\n576511\t591864\t相關的一些獎勵或是鼓勵的措施讓我們降低對國外的這些藥廠的依賴我為什麼這麼講其實衛福部應該不只是可以扶持民間的藥廠我們還有相關的一些能力可以做整合\n593131\t615641\t對不對 投入開發 都可以做我要以韓國為例韓國在2000年成立國家癌症中心不僅整合國內的癌症各項業務也包含臨床的治療研究等項目最重要最重要的是他本身也有研發癌症藥物的能力他們已經自主研發多項抗癌先藥涵蓋免疫療法標靶藥以及能量代謝抑制劑\n617314\t632150\t然後從南海的媒體數據資料也看出南海癌症的整體死亡率2002年到2013年年年均下降到2.8%然後2013到2021是最近的已經下降到3.2%同時我再一個資料\n635990\t662155\t那個資料沒有把我顯示出來嗎你生病了嗎同時對比台灣年齡標準化的這個癌症的死亡率2024年台灣每10萬人就有大約113人死於癌症南韓大約是61人他不到我們一半喔差不多一半啦 差不多一半如果按照南韓的人口數對比起來少之又少\n663394\t684099\t少之又少那天下雜誌在2022年又有一個專題報告就是韓國做了什麼20年前做了一個決定如今罹癌率死亡率都比台灣低開頭就講韓國的癌症發生率死亡率都低於台日五年存活率更高達78背後關鍵就是在2000年成立國家癌症中心\n685589\t710601\t這是天下大事的一個報導 給部長做參考也就是說有資源有預算還有整個政策的這個支持人家的成果就是如此他們的國營也不用在那邊擔心藥價會不會漲 太過擔憂那如果對照台灣我們現在只有行政院的中央癌症防治匯報還有國衛院的癌症研究所\n711687\t733163\t對不對 是好 部長你知道你有參與這個行政院的中央癌症紅字會報嗎有啊 有嘛那一年開幾次會應該至少每半年開一次會有嗎有有有 我們都有去參加應該是沒有吧我的資料裡面是111年到113年這三年就只有在12月開一次會\n742560\t763712\t主責當然是國健署跟健保署嘛再加上國衛院轄下的癌症研究所因為在場應該有國健跟健保署嘛可以問一下這三年是不是都12月才開一次會我要跟部長提醒的啦不是開會幾次的重要性與否啦是這個功能性嘛對照韓國\n765117\t779593\t人家一個國家級的一個癌症這個中心可以創造出這麼大的一個成績的效果出來降低他們癌症的死亡率降低他們致癌的這樣一個比例然後包含開發了這麼多的一個新藥\n781189\t799765\t它幾乎是一個國家級的一個癌症中心它給予所有的功能於一切啦所以才有辦法去打造那個降低死亡率的目標我們要配合賴總統的健康台灣我們到2023年要降低癌症死亡率三分之一我們不能沒有積極的作為啊\n800680\t822899\t一定要更多一些機器的作為嘛那我是拿韓國的例子可以做參考部長當然還是可以其他參照其他國家嘛那如果韓國的案子可以參考是不是趕快來做一些相關研究然後一個月內給委員會做一個報告那我們知道說我們要如何在2031年可以降低癌症的死亡率達到三分之一\n823379\t838768\t好的 可以吧我們大概三支箭嘛第一個是癌症早期篩檢請大家民眾篩檢這個我知道 現在的篩檢也擴大了也增加了40億第二個就是癌症的基因檢測以做精準的一個治療然後\n840009\t866967\t我看我們健保室每天都在公布又有什麼癌藥進來進來所以其實今年進了很多很多的癌藥對於醫師來講在治療上面真的多了很多的力氣這個大概都會都一定可以降低我們的一個五年的提升五年存活力那這個部分如果是不是說現在台灣是這樣各個醫院都已經這麼大間去那裡因為白龍有綜藝職\n869469\t892066\t台大他現在資質運作 電子機也資質運作所以在台灣也許要用我們這樣的一個情況我們怎麼樣集合大家的力量是用什麼方式 這的確是可以正如委員所講的來思考但是協調整合這個是一定\n893027\t920262\t都有 其實也一直這幾十年也一直有在做我知道你們都有在做但是我只是用韓國例子來講 它是2000年就要比我們在講長照日本的健康保險也是2000年開始那台灣在2000年跟2025年之間我們對防癌降低癌症死亡率都有在做這個署長也都是很記在做但是我只是講說用一個韓國例子來跟你做參考其他有其他國家的例子也都可以讓部長參考\n921263\t933585\t我們要如何在這三事件已經發動的時候短短短的時間2030年現在經濟恐慌出沒四年多不是出五年 出沒四年多我們要去降到三分之一\n935212\t957410\t我們會有很大很大的挑戰啊 還等到川普大帝會不會這樣會不會這樣那個藥劑我們要去因應因應嘛那剛剛聽部長講那時候我當然替這些癌友感到窩心嘛 感到溫暖嘛最起碼不能再造成他們增加這些癌症新藥的 癌症藥物的一些負擔嘛不管關稅如何去做調整嘛\n958130\t981812\t其實部長講這些話 坦白講就已足夠了啦但是我們還是期待說可以達到2030年這樣的一個目標所以我才會擔憂 才會用韓國的例子來給部長做參考 給署長做參考我們來瞭解韓國他的做法然後跟我們現在台灣怎麼做 也許是有什麼我們來做一個比較 再跟委員報告分析好 最後這個是召委多給我的時間 我再講一下因為跟屏東有關係 所以要講一下\n982552\t1004602\t昨天又有颱風再度掃過這個我們受災嚴重中南部嘛在風災之後登革熱就是異化的時間點我想這個大家都知道那中國現在又爆發這個屈公病那屈公病又跟這個登革熱一樣都是透過這個埃及斑蚊還有白腺斑蚊的傳染的疾病這民眾會恐慌啦那部長應該還記得2023年那時候是薛部長他為了這個事情還到雲林應該有兩趟因為那個時候\n1010164\t1030275\t是從2015年來爆發最嚴重的一次將近本土確診病例登革熱的這樣的一個對象高達兩萬人左右當時嚴重到必須要封閉農民的果園消毒也造成農民在整個嚴重的經濟損失所以那一年我才跟這個\n1031915\t1043789\t當地的林鄉長還有在地的一些民代跑到行政院來跟行政院做一些緩令最後行政院核定了一千八百多萬的登革熱傳染病溶損補助\n1045356\t1069872\t這也算是破紀錄啦因為整個都封起來了農民沒有辦法沒有辦法去守恆嘛沒有辦法去採收嘛 對不對沒有辦法去補肥嘛沒有辦法去噴農藥嘛因為將農藥回到野外就比農藥還差一筒啊所以那組成農民的經濟損失嘛不才會去啟動來做這個步驟嘛我覺得是說因為鳳梯 丹南市 丹南零七二八現在還洋流\n1070872\t1090420\t這個事後可能在很快的很短的時間內會不會造成這個登革熱還有這個區公併的區公併當然也是境外的一個防堵嘛那登革熱是有可能本土的又再起所以可能要未雨綢繆如果不積極的趕快去做相關的一些因應那到時候政府又要投入很大的人力物力甚至預算\n1091365\t1105644\t所以請部長一個星期內可能一個星期還太久我覺得因為洋流已經過了嘛所以我們從風災來之前都一直在做宣導\n1106385\t1131917\t同時也督導地方的衛生局在環境的清潔上面特別要注意到登革熱的相關的疫苗的一個預防那也 氣功病其實也是沒有人傳播他也不會人傳染所以是一樣的啦也是要清到 循道清刷一樣去把它落實啦希望就不要避免到對人民更進一步的傷害好 謝謝了 謝謝部長 謝謝署長主席請站起來 謝謝\n1135202\t1136474\t謝謝你講了十分鐘啊\n","txt":"趙偉辛苦請坐有請部長部長美國總統川普8月5號我沒有問你認不認識不要誤會8月5號的時候在接受媒體採訪的時候有公開表示會先對藥品課一個小關稅但一年到一年半之間稅率將提高到150%然後會再提高到250%\n因此他希望藥品要在他們美國國內生產這個川普大帝隨便講一句話即便還沒有發生都還沒有發生就會造成全球大混亂因為他這句話果不其然全球的藥廠開始緊張所以因此趙偉今天再排一次我4月7日已經排過一次了你看趙偉多用心然後也緊張這個事情所以再排這一次的專報\n邀請大家一起在這些討論所以我針對這個議題我特別在關心因為在11本月11日的時候又有一篇報導部長請看一下是大家上去說藥廠為了維持利潤可能會把這個成本轉嫁到其他國家全球藥價都會飆漲漲幅恐怕超過兩成那有癌症病友就透露\n大家現在很焦慮因為光是一年的智慧藥物就百萬起跳如果藥價再漲半年可能就要多花五十萬恐怕人與戶惡\n然後 癌藥的三大優略裡面 部長再看一下已經智慧用藥的癌藥 若藥價再持續上漲那癌藥恐怕就難以負擔那第二 若癌藥漲價目前已經在健保幾戶中的癌藥會不會有重新溢價或退出的問題那第三 對可能準備納入健保的癌藥會不會因為這波的關稅衝擊 最終變成無法納入部長有掌握嗎\n謝謝召委的關心這的確是我們政府應該努力的我們現在追求癌症的死亡率標準死亡率在2030年要降低三分之一怎麼樣給病人最好的一個早期的篩檢然後適當的精準的一個基因檢測然後精準的治療其實是很需要藥物的我們政府尤其衛護部這邊一定全力\n不管是在健保或智慧的支付方面一定不要去增加癌友的一個負擔這是一個最大的原則一定不要去增加癌友的負擔面對到關稅的衝擊哪怕調到150到250就是不能讓癌友增加這些藥物的費用的負擔嘛 對不對我想我們一定要以這樣來做最大的原則OK 好 謝謝有些做法讓時事長知道\n這個衝擊真的是蠻大的那未來到底會走到什麼程度我們會密切的注意不過我們盤點那麼因應如果這個全球的這些藥價都一起漲的時候那麼我們最大的衝擊會是在於還在專利期內的藥就是我們\n其他都還有溢價空間可是專利期內的藥通常它的那個寡占性比較強所以我們首先先盤點這個在專利期內的藥還有多少項以健保來講還有214項左右是屬於專利期的藥專利期內的藥大概一年的現在健保的支出大概在390億左右\n那這裡面呢如果又是把它屬於基本就是必要藥品的那大概是在75項左右那麼大概是200億啦所以我們在短期內呢當然會需要多一點這個費用來挹注因應這個萬一調漲的時候我們比較沒有那個溢價空間就只好要多付出一些啦那第二個呢是這些專利\n的藥呢在未來五六年內大概有76個品項他會過專利期所以我們要鼓勵這個趕快這個過專利期的趕快有這個學名藥或生物相似藥來遞汰他的藥價就會比較低所以我們也有一個鼓勵的措施就是如果你在這個專利期一過的五年內來提出的這個\n这个学名药或者是生物相似药前两张我们价格让它跟原厂一样来分散这个用药的风险这个是第二个那当然第三个就是学名药的鼓励这里面还是有很多会是学名药所以我们也鼓励学名药我们去年先从生物相似药开始那今年我们就鼓励癌症的化学药\n那麼學名藥我們也鼓勵也有這個獎勵的措施明年我們開始會把所有的癌症的用藥的學名藥也都納入我們獎勵所以我們這樣一步一步來因應好 我時間很足夠讓署長一一做這樣的說明 對不對所以你已經占了我的質詢一半的時間請主席要補回來給我但是言而總之 總而言之就是我聽部長那句話\n不管美國的關稅如何調整 對藥價的關稅如何調整總而言之 言而總之就不能讓我們的癌友因為關稅的調整造成他更大的負擔我就是聽這句話但是這還是要有相關的一些因應作用跟配套簡單講 不管150還是250 衛生部應該盡速針對癌症 寒病重症這三類別 提出藥品別\n這個治療線別還有病類別可能受到這個衝擊評估及領域調查我想這個應該要做吧好 這個一直有在做但是因為川普一直變化我們也會隨之他來調整OK\n這個如果有必要的話隨時可以做相關的報告好 因為川普一直在變化所以你們也是做相關的一些調查也是要跟著變動 這個我很清楚但是我這邊可以再跟部長建議一下主動監控這些\n這些藥品就是跟特別講的癌症含病重症的他的這個智慧藥品的價格波動緊密的追蹤國內藥品價格是我受到國際因素的提高並隨時提出相關的因素措施避免市長這個訊息不對稱造成恐慌性的加價這可以吧\n當然 這應該要這樣做你要這樣做 你沒有這樣做嗎你沒有隨著川普的變動做這樣一個市場執行的監控嗎應該沒有吧那個食藥署要不要回答一下\n不好意思 要用你的時間好 已經超過四分之三了這個主席會補給我對藥品的監控的話我們在於我們的製劑要兩個到三個月如果在半年前製劑已經有短缺的在通報系統上面通報我們啟動整個藥學會的評估\n必要之時我們可以做專案的進口跟專案的輸入以及做藥品的調控那接下來其實是更進一步在藥事法二十七之三條所有不見得是在必要藥品在所有藥品的短缺的情況之下需要有一個進入調配的機制政府能夠進一步的介入那這個部分是我們目前是希望能夠智慧導入的不是 我是所長我請教部長的是針對價格的部分\n你是在回應我是針對到時候我缺這些藥品的時候可以從怎樣來輸入嘛對不對我是針對這個價格的部分啦我想因為自費藥品的價格部分在食藥署其實我們這邊沒有特別的定價的這個的一個的一個權責在裡面我們這些其實是針對所以你意思是部長找你上來打呼我就不對了嘛他找錯人了自費其實是好\n我想智慧的藥品也是對這些集中重症和寒病的病人很大的負擔所以這個一定要我們站在政府的立場一定要監測而且不能讓他隨意負擔增加我想這個部分所以請大家不要也請藥廠不能\n不能隨便加價也不要有恐慌的加價的現象好 那就請部長跟委員會做一個說明你們的監測機制應該就是在因應這個美國關稅過程裡面馬上就啟動嘛然後適時的再去公布這些相關的訊息嘛好 我們馬上啟動OK 好 謝謝價格的一個波動\n謝謝 好 第二個題目剛剛部長有答覆我嘛我們要追求到2031年把這個癌症致死率降到這個三分之一嘛 對不對降至三分之一嘛但是從長遠來看 我覺得台灣必定要盡速扶持國家的生技產業啦這個部分絕對不是衛部 這是跨部會包含經濟部等等等 包含國華會嘛\n我想現在要去鼓勵外國的大型的藥廠來台灣投資設廠我看也困難了啦因為美國是希望到他們的國家去設嘛才免除這個關稅的問題嘛但是相對的我們不用去鼓勵國外的來設廠那國內的可能你要大肆的來做\n相關的一些獎勵或是鼓勵的措施讓我們降低對國外的這些藥廠的依賴我為什麼這麼講其實衛福部應該不只是可以扶持民間的藥廠我們還有相關的一些能力可以做整合\n對不對 投入開發 都可以做我要以韓國為例韓國在2000年成立國家癌症中心不僅整合國內的癌症各項業務也包含臨床的治療研究等項目最重要最重要的是他本身也有研發癌症藥物的能力他們已經自主研發多項抗癌先藥涵蓋免疫療法標靶藥以及能量代謝抑制劑\n然後從南海的媒體數據資料也看出南海癌症的整體死亡率2002年到2013年年年均下降到2.8%然後2013到2021是最近的已經下降到3.2%同時我再一個資料\n那個資料沒有把我顯示出來嗎你生病了嗎同時對比台灣年齡標準化的這個癌症的死亡率2024年台灣每10萬人就有大約113人死於癌症南韓大約是61人他不到我們一半喔差不多一半啦 差不多一半如果按照南韓的人口數對比起來少之又少\n少之又少那天下雜誌在2022年又有一個專題報告就是韓國做了什麼20年前做了一個決定如今罹癌率死亡率都比台灣低開頭就講韓國的癌症發生率死亡率都低於台日五年存活率更高達78背後關鍵就是在2000年成立國家癌症中心\n這是天下大事的一個報導 給部長做參考也就是說有資源有預算還有整個政策的這個支持人家的成果就是如此他們的國營也不用在那邊擔心藥價會不會漲 太過擔憂那如果對照台灣我們現在只有行政院的中央癌症防治匯報還有國衛院的癌症研究所\n對不對 是好 部長你知道你有參與這個行政院的中央癌症紅字會報嗎有啊 有嘛那一年開幾次會應該至少每半年開一次會有嗎有有有 我們都有去參加應該是沒有吧我的資料裡面是111年到113年這三年就只有在12月開一次會\n主責當然是國健署跟健保署嘛再加上國衛院轄下的癌症研究所因為在場應該有國健跟健保署嘛可以問一下這三年是不是都12月才開一次會我要跟部長提醒的啦不是開會幾次的重要性與否啦是這個功能性嘛對照韓國\n人家一個國家級的一個癌症這個中心可以創造出這麼大的一個成績的效果出來降低他們癌症的死亡率降低他們致癌的這樣一個比例然後包含開發了這麼多的一個新藥\n它幾乎是一個國家級的一個癌症中心它給予所有的功能於一切啦所以才有辦法去打造那個降低死亡率的目標我們要配合賴總統的健康台灣我們到2023年要降低癌症死亡率三分之一我們不能沒有積極的作為啊\n一定要更多一些機器的作為嘛那我是拿韓國的例子可以做參考部長當然還是可以其他參照其他國家嘛那如果韓國的案子可以參考是不是趕快來做一些相關研究然後一個月內給委員會做一個報告那我們知道說我們要如何在2031年可以降低癌症的死亡率達到三分之一\n好的 可以吧我們大概三支箭嘛第一個是癌症早期篩檢請大家民眾篩檢這個我知道 現在的篩檢也擴大了也增加了40億第二個就是癌症的基因檢測以做精準的一個治療然後\n我看我們健保室每天都在公布又有什麼癌藥進來進來所以其實今年進了很多很多的癌藥對於醫師來講在治療上面真的多了很多的力氣這個大概都會都一定可以降低我們的一個五年的提升五年存活力那這個部分如果是不是說現在台灣是這樣各個醫院都已經這麼大間去那裡因為白龍有綜藝職\n台大他現在資質運作 電子機也資質運作所以在台灣也許要用我們這樣的一個情況我們怎麼樣集合大家的力量是用什麼方式 這的確是可以正如委員所講的來思考但是協調整合這個是一定\n都有 其實也一直這幾十年也一直有在做我知道你們都有在做但是我只是用韓國例子來講 它是2000年就要比我們在講長照日本的健康保險也是2000年開始那台灣在2000年跟2025年之間我們對防癌降低癌症死亡率都有在做這個署長也都是很記在做但是我只是講說用一個韓國例子來跟你做參考其他有其他國家的例子也都可以讓部長參考\n我們要如何在這三事件已經發動的時候短短短的時間2030年現在經濟恐慌出沒四年多不是出五年 出沒四年多我們要去降到三分之一\n我們會有很大很大的挑戰啊 還等到川普大帝會不會這樣會不會這樣那個藥劑我們要去因應因應嘛那剛剛聽部長講那時候我當然替這些癌友感到窩心嘛 感到溫暖嘛最起碼不能再造成他們增加這些癌症新藥的 癌症藥物的一些負擔嘛不管關稅如何去做調整嘛\n其實部長講這些話 坦白講就已足夠了啦但是我們還是期待說可以達到2030年這樣的一個目標所以我才會擔憂 才會用韓國的例子來給部長做參考 給署長做參考我們來瞭解韓國他的做法然後跟我們現在台灣怎麼做 也許是有什麼我們來做一個比較 再跟委員報告分析好 最後這個是召委多給我的時間 我再講一下因為跟屏東有關係 所以要講一下\n昨天又有颱風再度掃過這個我們受災嚴重中南部嘛在風災之後登革熱就是異化的時間點我想這個大家都知道那中國現在又爆發這個屈公病那屈公病又跟這個登革熱一樣都是透過這個埃及斑蚊還有白腺斑蚊的傳染的疾病這民眾會恐慌啦那部長應該還記得2023年那時候是薛部長他為了這個事情還到雲林應該有兩趟因為那個時候\n是從2015年來爆發最嚴重的一次將近本土確診病例登革熱的這樣的一個對象高達兩萬人左右當時嚴重到必須要封閉農民的果園消毒也造成農民在整個嚴重的經濟損失所以那一年我才跟這個\n當地的林鄉長還有在地的一些民代跑到行政院來跟行政院做一些緩令最後行政院核定了一千八百多萬的登革熱傳染病溶損補助\n這也算是破紀錄啦因為整個都封起來了農民沒有辦法沒有辦法去守恆嘛沒有辦法去採收嘛 對不對沒有辦法去補肥嘛沒有辦法去噴農藥嘛因為將農藥回到野外就比農藥還差一筒啊所以那組成農民的經濟損失嘛不才會去啟動來做這個步驟嘛我覺得是說因為鳳梯 丹南市 丹南零七二八現在還洋流\n這個事後可能在很快的很短的時間內會不會造成這個登革熱還有這個區公併的區公併當然也是境外的一個防堵嘛那登革熱是有可能本土的又再起所以可能要未雨綢繆如果不積極的趕快去做相關的一些因應那到時候政府又要投入很大的人力物力甚至預算\n所以請部長一個星期內可能一個星期還太久我覺得因為洋流已經過了嘛所以我們從風災來之前都一直在做宣導\n同時也督導地方的衛生局在環境的清潔上面特別要注意到登革熱的相關的疫苗的一個預防那也 氣功病其實也是沒有人傳播他也不會人傳染所以是一樣的啦也是要清到 循道清刷一樣去把它落實啦希望就不要避免到對人民更進一步的傷害好 謝謝了 謝謝部長 謝謝署長主席請站起來 謝謝\n謝謝你講了十分鐘啊\n","vtt":"WEBVTT\n\n00:10.166 --> 00:36.016\n趙偉辛苦請坐有請部長部長美國總統川普8月5號我沒有問你認不認識不要誤會8月5號的時候在接受媒體採訪的時候有公開表示會先對藥品課一個小關稅但一年到一年半之間稅率將提高到150%然後會再提高到250%\n\n00:37.897 --> 01:02.566\n因此他希望藥品要在他們美國國內生產這個川普大帝隨便講一句話即便還沒有發生都還沒有發生就會造成全球大混亂因為他這句話果不其然全球的藥廠開始緊張所以因此趙偉今天再排一次我4月7日已經排過一次了你看趙偉多用心然後也緊張這個事情所以再排這一次的專報\n\n01:03.886 --> 01:24.242\n邀請大家一起在這些討論所以我針對這個議題我特別在關心因為在11本月11日的時候又有一篇報導部長請看一下是大家上去說藥廠為了維持利潤可能會把這個成本轉嫁到其他國家全球藥價都會飆漲漲幅恐怕超過兩成那有癌症病友就透露\n\n01:25.003 --> 01:33.738\n大家現在很焦慮因為光是一年的智慧藥物就百萬起跳如果藥價再漲半年可能就要多花五十萬恐怕人與戶惡\n\n01:35.973 --> 02:02.530\n然後癌藥的三大優略裡面部長再看一下已經智慧用藥的癌藥若藥價再持續上漲那癌藥恐怕就難以負擔那第二若癌藥漲價目前已經在健保幾戶中的癌藥會不會有重新溢價或退出的問題那第三對可能準備納入健保的癌藥會不會因為這波的關稅衝擊最終變成無法納入部長有掌握嗎\n\n02:05.679 --> 02:33.440\n謝謝召委的關心這的確是我們政府應該努力的我們現在追求癌症的死亡率標準死亡率在2030年要降低三分之一怎麼樣給病人最好的一個早期的篩檢然後適當的精準的一個基因檢測然後精準的治療其實是很需要藥物的我們政府尤其衛護部這邊一定全力\n\n02:34.221 --> 02:58.996\n不管是在健保或智慧的支付方面一定不要去增加癌友的一個負擔這是一個最大的原則一定不要去增加癌友的負擔面對到關稅的衝擊哪怕調到150到250就是不能讓癌友增加這些藥物的費用的負擔嘛對不對我想我們一定要以這樣來做最大的原則OK好謝謝有些做法讓時事長知道\n\n03:04.178 --> 03:20.893\n這個衝擊真的是蠻大的那未來到底會走到什麼程度我們會密切的注意不過我們盤點那麼因應如果這個全球的這些藥價都一起漲的時候那麼我們最大的衝擊會是在於還在專利期內的藥就是我們\n\n03:22.254 --> 03:44.659\n其他都還有溢價空間可是專利期內的藥通常它的那個寡占性比較強所以我們首先先盤點這個在專利期內的藥還有多少項以健保來講還有214項左右是屬於專利期的藥專利期內的藥大概一年的現在健保的支出大概在390億左右\n\n03:45.279 --> 04:13.295\n那這裡面呢如果又是把它屬於基本就是必要藥品的那大概是在75項左右那麼大概是200億啦所以我們在短期內呢當然會需要多一點這個費用來挹注因應這個萬一調漲的時候我們比較沒有那個溢價空間就只好要多付出一些啦那第二個呢是這些專利\n\n04:14.275 --> 04:37.034\n的藥呢在未來五六年內大概有76個品項他會過專利期所以我們要鼓勵這個趕快這個過專利期的趕快有這個學名藥或生物相似藥來遞汰他的藥價就會比較低所以我們也有一個鼓勵的措施就是如果你在這個專利期一過的五年內來提出的這個\n\n04:38.775 --> 05:04.487\n这个学名药或者是生物相似药前两张我们价格让它跟原厂一样来分散这个用药的风险这个是第二个那当然第三个就是学名药的鼓励这里面还是有很多会是学名药所以我们也鼓励学名药我们去年先从生物相似药开始那今年我们就鼓励癌症的化学药\n\n05:05.327 --> 05:30.765\n那麼學名藥我們也鼓勵也有這個獎勵的措施明年我們開始會把所有的癌症的用藥的學名藥也都納入我們獎勵所以我們這樣一步一步來因應好我時間很足夠讓署長一一做這樣的說明對不對所以你已經占了我的質詢一半的時間請主席要補回來給我但是言而總之總而言之就是我聽部長那句話\n\n05:31.906 --> 05:48.271\n不管美國的關稅如何調整對藥價的關稅如何調整總而言之言而總之就不能讓我們的癌友因為關稅的調整造成他更大的負擔我就是聽這句話但是這還是要有相關的一些因應作用跟配套簡單講不管150還是250衛生部應該盡速針對癌症寒病重症這三類別提出藥品別\n\n05:59.155 --> 06:12.868\n這個治療線別還有病類別可能受到這個衝擊評估及領域調查我想這個應該要做吧好這個一直有在做但是因為川普一直變化我們也會隨之他來調整OK\n\n06:14.403 --> 06:27.591\n這個如果有必要的話隨時可以做相關的報告好因為川普一直在變化所以你們也是做相關的一些調查也是要跟著變動這個我很清楚但是我這邊可以再跟部長建議一下主動監控這些\n\n06:29.765 --> 06:46.973\n這些藥品就是跟特別講的癌症含病重症的他的這個智慧藥品的價格波動緊密的追蹤國內藥品價格是我受到國際因素的提高並隨時提出相關的因素措施避免市長這個訊息不對稱造成恐慌性的加價這可以吧\n\n06:49.233 --> 07:00.252\n當然這應該要這樣做你要這樣做你沒有這樣做嗎你沒有隨著川普的變動做這樣一個市場執行的監控嗎應該沒有吧那個食藥署要不要回答一下\n\n07:03.171 --> 07:19.177\n不好意思要用你的時間好已經超過四分之三了這個主席會補給我對藥品的監控的話我們在於我們的製劑要兩個到三個月如果在半年前製劑已經有短缺的在通報系統上面通報我們啟動整個藥學會的評估\n\n07:21.118 --> 07:46.858\n必要之時我們可以做專案的進口跟專案的輸入以及做藥品的調控那接下來其實是更進一步在藥事法二十七之三條所有不見得是在必要藥品在所有藥品的短缺的情況之下需要有一個進入調配的機制政府能夠進一步的介入那這個部分是我們目前是希望能夠智慧導入的不是我是所長我請教部長的是針對價格的部分\n\n07:47.979 --> 08:11.946\n你是在回應我是針對到時候我缺這些藥品的時候可以從怎樣來輸入嘛對不對我是針對這個價格的部分啦我想因為自費藥品的價格部分在食藥署其實我們這邊沒有特別的定價的這個的一個的一個權責在裡面我們這些其實是針對所以你意思是部長找你上來打呼我就不對了嘛他找錯人了自費其實是好\n\n08:16.927 --> 08:35.670\n我想智慧的藥品也是對這些集中重症和寒病的病人很大的負擔所以這個一定要我們站在政府的立場一定要監測而且不能讓他隨意負擔增加我想這個部分所以請大家不要也請藥廠不能\n\n08:36.471 --> 08:52.567\n不能隨便加價也不要有恐慌的加價的現象好那就請部長跟委員會做一個說明你們的監測機制應該就是在因應這個美國關稅過程裡面馬上就啟動嘛然後適時的再去公布這些相關的訊息嘛好我們馬上啟動OK好謝謝價格的一個波動\n\n08:55.169 --> 09:16.320\n謝謝好第二個題目剛剛部長有答覆我嘛我們要追求到2031年把這個癌症致死率降到這個三分之一嘛對不對降至三分之一嘛但是從長遠來看我覺得台灣必定要盡速扶持國家的生技產業啦這個部分絕對不是衛部這是跨部會包含經濟部等等等包含國華會嘛\n\n09:17.681 --> 09:35.411\n我想現在要去鼓勵外國的大型的藥廠來台灣投資設廠我看也困難了啦因為美國是希望到他們的國家去設嘛才免除這個關稅的問題嘛但是相對的我們不用去鼓勵國外的來設廠那國內的可能你要大肆的來做\n\n09:36.511 --> 09:51.864\n相關的一些獎勵或是鼓勵的措施讓我們降低對國外的這些藥廠的依賴我為什麼這麼講其實衛福部應該不只是可以扶持民間的藥廠我們還有相關的一些能力可以做整合\n\n09:53.131 --> 10:15.641\n對不對投入開發都可以做我要以韓國為例韓國在2000年成立國家癌症中心不僅整合國內的癌症各項業務也包含臨床的治療研究等項目最重要最重要的是他本身也有研發癌症藥物的能力他們已經自主研發多項抗癌先藥涵蓋免疫療法標靶藥以及能量代謝抑制劑\n\n10:17.314 --> 10:32.150\n然後從南海的媒體數據資料也看出南海癌症的整體死亡率2002年到2013年年年均下降到2.8%然後2013到2021是最近的已經下降到3.2%同時我再一個資料\n\n10:35.990 --> 11:02.155\n那個資料沒有把我顯示出來嗎你生病了嗎同時對比台灣年齡標準化的這個癌症的死亡率2024年台灣每10萬人就有大約113人死於癌症南韓大約是61人他不到我們一半喔差不多一半啦差不多一半如果按照南韓的人口數對比起來少之又少\n\n11:03.394 --> 11:24.099\n少之又少那天下雜誌在2022年又有一個專題報告就是韓國做了什麼20年前做了一個決定如今罹癌率死亡率都比台灣低開頭就講韓國的癌症發生率死亡率都低於台日五年存活率更高達78背後關鍵就是在2000年成立國家癌症中心\n\n11:25.589 --> 11:50.601\n這是天下大事的一個報導給部長做參考也就是說有資源有預算還有整個政策的這個支持人家的成果就是如此他們的國營也不用在那邊擔心藥價會不會漲太過擔憂那如果對照台灣我們現在只有行政院的中央癌症防治匯報還有國衛院的癌症研究所\n\n11:51.687 --> 12:13.163\n對不對是好部長你知道你有參與這個行政院的中央癌症紅字會報嗎有啊有嘛那一年開幾次會應該至少每半年開一次會有嗎有有有我們都有去參加應該是沒有吧我的資料裡面是111年到113年這三年就只有在12月開一次會\n\n12:22.560 --> 12:43.712\n主責當然是國健署跟健保署嘛再加上國衛院轄下的癌症研究所因為在場應該有國健跟健保署嘛可以問一下這三年是不是都12月才開一次會我要跟部長提醒的啦不是開會幾次的重要性與否啦是這個功能性嘛對照韓國\n\n12:45.117 --> 12:59.593\n人家一個國家級的一個癌症這個中心可以創造出這麼大的一個成績的效果出來降低他們癌症的死亡率降低他們致癌的這樣一個比例然後包含開發了這麼多的一個新藥\n\n13:01.189 --> 13:19.765\n它幾乎是一個國家級的一個癌症中心它給予所有的功能於一切啦所以才有辦法去打造那個降低死亡率的目標我們要配合賴總統的健康台灣我們到2023年要降低癌症死亡率三分之一我們不能沒有積極的作為啊\n\n13:20.680 --> 13:42.899\n一定要更多一些機器的作為嘛那我是拿韓國的例子可以做參考部長當然還是可以其他參照其他國家嘛那如果韓國的案子可以參考是不是趕快來做一些相關研究然後一個月內給委員會做一個報告那我們知道說我們要如何在2031年可以降低癌症的死亡率達到三分之一\n\n13:43.379 --> 13:58.768\n好的可以吧我們大概三支箭嘛第一個是癌症早期篩檢請大家民眾篩檢這個我知道現在的篩檢也擴大了也增加了40億第二個就是癌症的基因檢測以做精準的一個治療然後\n\n14:00.009 --> 14:26.967\n我看我們健保室每天都在公布又有什麼癌藥進來進來所以其實今年進了很多很多的癌藥對於醫師來講在治療上面真的多了很多的力氣這個大概都會都一定可以降低我們的一個五年的提升五年存活力那這個部分如果是不是說現在台灣是這樣各個醫院都已經這麼大間去那裡因為白龍有綜藝職\n\n14:29.469 --> 14:52.066\n台大他現在資質運作電子機也資質運作所以在台灣也許要用我們這樣的一個情況我們怎麼樣集合大家的力量是用什麼方式這的確是可以正如委員所講的來思考但是協調整合這個是一定\n\n14:53.027 --> 15:20.262\n都有其實也一直這幾十年也一直有在做我知道你們都有在做但是我只是用韓國例子來講它是2000年就要比我們在講長照日本的健康保險也是2000年開始那台灣在2000年跟2025年之間我們對防癌降低癌症死亡率都有在做這個署長也都是很記在做但是我只是講說用一個韓國例子來跟你做參考其他有其他國家的例子也都可以讓部長參考\n\n15:21.263 --> 15:33.585\n我們要如何在這三事件已經發動的時候短短短的時間2030年現在經濟恐慌出沒四年多不是出五年出沒四年多我們要去降到三分之一\n\n15:35.212 --> 15:57.410\n我們會有很大很大的挑戰啊還等到川普大帝會不會這樣會不會這樣那個藥劑我們要去因應因應嘛那剛剛聽部長講那時候我當然替這些癌友感到窩心嘛感到溫暖嘛最起碼不能再造成他們增加這些癌症新藥的癌症藥物的一些負擔嘛不管關稅如何去做調整嘛\n\n15:58.130 --> 16:21.812\n其實部長講這些話坦白講就已足夠了啦但是我們還是期待說可以達到2030年這樣的一個目標所以我才會擔憂才會用韓國的例子來給部長做參考給署長做參考我們來瞭解韓國他的做法然後跟我們現在台灣怎麼做也許是有什麼我們來做一個比較再跟委員報告分析好最後這個是召委多給我的時間我再講一下因為跟屏東有關係所以要講一下\n\n16:22.552 --> 16:44.602\n昨天又有颱風再度掃過這個我們受災嚴重中南部嘛在風災之後登革熱就是異化的時間點我想這個大家都知道那中國現在又爆發這個屈公病那屈公病又跟這個登革熱一樣都是透過這個埃及斑蚊還有白腺斑蚊的傳染的疾病這民眾會恐慌啦那部長應該還記得2023年那時候是薛部長他為了這個事情還到雲林應該有兩趟因為那個時候\n\n16:50.164 --> 17:10.275\n是從2015年來爆發最嚴重的一次將近本土確診病例登革熱的這樣的一個對象高達兩萬人左右當時嚴重到必須要封閉農民的果園消毒也造成農民在整個嚴重的經濟損失所以那一年我才跟這個\n\n17:11.915 --> 17:23.789\n當地的林鄉長還有在地的一些民代跑到行政院來跟行政院做一些緩令最後行政院核定了一千八百多萬的登革熱傳染病溶損補助\n\n17:25.356 --> 17:49.872\n這也算是破紀錄啦因為整個都封起來了農民沒有辦法沒有辦法去守恆嘛沒有辦法去採收嘛對不對沒有辦法去補肥嘛沒有辦法去噴農藥嘛因為將農藥回到野外就比農藥還差一筒啊所以那組成農民的經濟損失嘛不才會去啟動來做這個步驟嘛我覺得是說因為鳳梯丹南市丹南零七二八現在還洋流\n\n17:50.872 --> 18:10.420\n這個事後可能在很快的很短的時間內會不會造成這個登革熱還有這個區公併的區公併當然也是境外的一個防堵嘛那登革熱是有可能本土的又再起所以可能要未雨綢繆如果不積極的趕快去做相關的一些因應那到時候政府又要投入很大的人力物力甚至預算\n\n18:11.365 --> 18:25.644\n所以請部長一個星期內可能一個星期還太久我覺得因為洋流已經過了嘛所以我們從風災來之前都一直在做宣導\n\n18:26.385 --> 18:51.917\n同時也督導地方的衛生局在環境的清潔上面特別要注意到登革熱的相關的疫苗的一個預防那也氣功病其實也是沒有人傳播他也不會人傳染所以是一樣的啦也是要清到循道清刷一樣去把它落實啦希望就不要避免到對人民更進一步的傷害好謝謝了謝謝部長謝謝署長主席請站起來謝謝\n\n18:55.202 --> 18:56.474\n謝謝你講了十分鐘啊\n\n","segments":[{"start":10.166,"end":36.016,"text":"趙偉辛苦請坐有請部長部長美國總統川普8月5號我沒有問你認不認識不要誤會8月5號的時候在接受媒體採訪的時候有公開表示會先對藥品課一個小關稅但一年到一年半之間稅率將提高到150%然後會再提高到250%"},{"start":37.897,"end":62.566,"text":"因此他希望藥品要在他們美國國內生產這個川普大帝隨便講一句話即便還沒有發生都還沒有發生就會造成全球大混亂因為他這句話果不其然全球的藥廠開始緊張所以因此趙偉今天再排一次我4月7日已經排過一次了你看趙偉多用心然後也緊張這個事情所以再排這一次的專報"},{"start":63.886,"end":84.242,"text":"邀請大家一起在這些討論所以我針對這個議題我特別在關心因為在11本月11日的時候又有一篇報導部長請看一下是大家上去說藥廠為了維持利潤可能會把這個成本轉嫁到其他國家全球藥價都會飆漲漲幅恐怕超過兩成那有癌症病友就透露"},{"start":85.003,"end":93.738,"text":"大家現在很焦慮因為光是一年的智慧藥物就百萬起跳如果藥價再漲半年可能就要多花五十萬恐怕人與戶惡"},{"start":95.973,"end":122.53,"text":"然後 癌藥的三大優略裡面 部長再看一下已經智慧用藥的癌藥 若藥價再持續上漲那癌藥恐怕就難以負擔那第二 若癌藥漲價目前已經在健保幾戶中的癌藥會不會有重新溢價或退出的問題那第三 對可能準備納入健保的癌藥會不會因為這波的關稅衝擊 最終變成無法納入部長有掌握嗎"},{"start":125.679,"end":153.44,"text":"謝謝召委的關心這的確是我們政府應該努力的我們現在追求癌症的死亡率標準死亡率在2030年要降低三分之一怎麼樣給病人最好的一個早期的篩檢然後適當的精準的一個基因檢測然後精準的治療其實是很需要藥物的我們政府尤其衛護部這邊一定全力"},{"start":154.221,"end":178.996,"text":"不管是在健保或智慧的支付方面一定不要去增加癌友的一個負擔這是一個最大的原則一定不要去增加癌友的負擔面對到關稅的衝擊哪怕調到150到250就是不能讓癌友增加這些藥物的費用的負擔嘛 對不對我想我們一定要以這樣來做最大的原則OK 好 謝謝有些做法讓時事長知道"},{"start":184.178,"end":200.893,"text":"這個衝擊真的是蠻大的那未來到底會走到什麼程度我們會密切的注意不過我們盤點那麼因應如果這個全球的這些藥價都一起漲的時候那麼我們最大的衝擊會是在於還在專利期內的藥就是我們"},{"start":202.254,"end":224.659,"text":"其他都還有溢價空間可是專利期內的藥通常它的那個寡占性比較強所以我們首先先盤點這個在專利期內的藥還有多少項以健保來講還有214項左右是屬於專利期的藥專利期內的藥大概一年的現在健保的支出大概在390億左右"},{"start":225.279,"end":253.295,"text":"那這裡面呢如果又是把它屬於基本就是必要藥品的那大概是在75項左右那麼大概是200億啦所以我們在短期內呢當然會需要多一點這個費用來挹注因應這個萬一調漲的時候我們比較沒有那個溢價空間就只好要多付出一些啦那第二個呢是這些專利"},{"start":254.275,"end":277.034,"text":"的藥呢在未來五六年內大概有76個品項他會過專利期所以我們要鼓勵這個趕快這個過專利期的趕快有這個學名藥或生物相似藥來遞汰他的藥價就會比較低所以我們也有一個鼓勵的措施就是如果你在這個專利期一過的五年內來提出的這個"},{"start":278.775,"end":304.487,"text":"这个学名药或者是生物相似药前两张我们价格让它跟原厂一样来分散这个用药的风险这个是第二个那当然第三个就是学名药的鼓励这里面还是有很多会是学名药所以我们也鼓励学名药我们去年先从生物相似药开始那今年我们就鼓励癌症的化学药"},{"start":305.327,"end":330.765,"text":"那麼學名藥我們也鼓勵也有這個獎勵的措施明年我們開始會把所有的癌症的用藥的學名藥也都納入我們獎勵所以我們這樣一步一步來因應好 我時間很足夠讓署長一一做這樣的說明 對不對所以你已經占了我的質詢一半的時間請主席要補回來給我但是言而總之 總而言之就是我聽部長那句話"},{"start":331.906,"end":348.271,"text":"不管美國的關稅如何調整 對藥價的關稅如何調整總而言之 言而總之就不能讓我們的癌友因為關稅的調整造成他更大的負擔我就是聽這句話但是這還是要有相關的一些因應作用跟配套簡單講 不管150還是250 衛生部應該盡速針對癌症 寒病重症這三類別 提出藥品別"},{"start":359.155,"end":372.868,"text":"這個治療線別還有病類別可能受到這個衝擊評估及領域調查我想這個應該要做吧好 這個一直有在做但是因為川普一直變化我們也會隨之他來調整OK"},{"start":374.403,"end":387.591,"text":"這個如果有必要的話隨時可以做相關的報告好 因為川普一直在變化所以你們也是做相關的一些調查也是要跟著變動 這個我很清楚但是我這邊可以再跟部長建議一下主動監控這些"},{"start":389.765,"end":406.973,"text":"這些藥品就是跟特別講的癌症含病重症的他的這個智慧藥品的價格波動緊密的追蹤國內藥品價格是我受到國際因素的提高並隨時提出相關的因素措施避免市長這個訊息不對稱造成恐慌性的加價這可以吧"},{"start":409.233,"end":420.252,"text":"當然 這應該要這樣做你要這樣做 你沒有這樣做嗎你沒有隨著川普的變動做這樣一個市場執行的監控嗎應該沒有吧那個食藥署要不要回答一下"},{"start":423.171,"end":439.177,"text":"不好意思 要用你的時間好 已經超過四分之三了這個主席會補給我對藥品的監控的話我們在於我們的製劑要兩個到三個月如果在半年前製劑已經有短缺的在通報系統上面通報我們啟動整個藥學會的評估"},{"start":441.118,"end":466.858,"text":"必要之時我們可以做專案的進口跟專案的輸入以及做藥品的調控那接下來其實是更進一步在藥事法二十七之三條所有不見得是在必要藥品在所有藥品的短缺的情況之下需要有一個進入調配的機制政府能夠進一步的介入那這個部分是我們目前是希望能夠智慧導入的不是 我是所長我請教部長的是針對價格的部分"},{"start":467.979,"end":491.946,"text":"你是在回應我是針對到時候我缺這些藥品的時候可以從怎樣來輸入嘛對不對我是針對這個價格的部分啦我想因為自費藥品的價格部分在食藥署其實我們這邊沒有特別的定價的這個的一個的一個權責在裡面我們這些其實是針對所以你意思是部長找你上來打呼我就不對了嘛他找錯人了自費其實是好"},{"start":496.927,"end":515.67,"text":"我想智慧的藥品也是對這些集中重症和寒病的病人很大的負擔所以這個一定要我們站在政府的立場一定要監測而且不能讓他隨意負擔增加我想這個部分所以請大家不要也請藥廠不能"},{"start":516.471,"end":532.567,"text":"不能隨便加價也不要有恐慌的加價的現象好 那就請部長跟委員會做一個說明你們的監測機制應該就是在因應這個美國關稅過程裡面馬上就啟動嘛然後適時的再去公布這些相關的訊息嘛好 我們馬上啟動OK 好 謝謝價格的一個波動"},{"start":535.169,"end":556.32,"text":"謝謝 好 第二個題目剛剛部長有答覆我嘛我們要追求到2031年把這個癌症致死率降到這個三分之一嘛 對不對降至三分之一嘛但是從長遠來看 我覺得台灣必定要盡速扶持國家的生技產業啦這個部分絕對不是衛部 這是跨部會包含經濟部等等等 包含國華會嘛"},{"start":557.681,"end":575.411,"text":"我想現在要去鼓勵外國的大型的藥廠來台灣投資設廠我看也困難了啦因為美國是希望到他們的國家去設嘛才免除這個關稅的問題嘛但是相對的我們不用去鼓勵國外的來設廠那國內的可能你要大肆的來做"},{"start":576.511,"end":591.864,"text":"相關的一些獎勵或是鼓勵的措施讓我們降低對國外的這些藥廠的依賴我為什麼這麼講其實衛福部應該不只是可以扶持民間的藥廠我們還有相關的一些能力可以做整合"},{"start":593.131,"end":615.641,"text":"對不對 投入開發 都可以做我要以韓國為例韓國在2000年成立國家癌症中心不僅整合國內的癌症各項業務也包含臨床的治療研究等項目最重要最重要的是他本身也有研發癌症藥物的能力他們已經自主研發多項抗癌先藥涵蓋免疫療法標靶藥以及能量代謝抑制劑"},{"start":617.314,"end":632.15,"text":"然後從南海的媒體數據資料也看出南海癌症的整體死亡率2002年到2013年年年均下降到2.8%然後2013到2021是最近的已經下降到3.2%同時我再一個資料"},{"start":635.99,"end":662.155,"text":"那個資料沒有把我顯示出來嗎你生病了嗎同時對比台灣年齡標準化的這個癌症的死亡率2024年台灣每10萬人就有大約113人死於癌症南韓大約是61人他不到我們一半喔差不多一半啦 差不多一半如果按照南韓的人口數對比起來少之又少"},{"start":663.394,"end":684.099,"text":"少之又少那天下雜誌在2022年又有一個專題報告就是韓國做了什麼20年前做了一個決定如今罹癌率死亡率都比台灣低開頭就講韓國的癌症發生率死亡率都低於台日五年存活率更高達78背後關鍵就是在2000年成立國家癌症中心"},{"start":685.589,"end":710.601,"text":"這是天下大事的一個報導 給部長做參考也就是說有資源有預算還有整個政策的這個支持人家的成果就是如此他們的國營也不用在那邊擔心藥價會不會漲 太過擔憂那如果對照台灣我們現在只有行政院的中央癌症防治匯報還有國衛院的癌症研究所"},{"start":711.687,"end":733.163,"text":"對不對 是好 部長你知道你有參與這個行政院的中央癌症紅字會報嗎有啊 有嘛那一年開幾次會應該至少每半年開一次會有嗎有有有 我們都有去參加應該是沒有吧我的資料裡面是111年到113年這三年就只有在12月開一次會"},{"start":742.56,"end":763.712,"text":"主責當然是國健署跟健保署嘛再加上國衛院轄下的癌症研究所因為在場應該有國健跟健保署嘛可以問一下這三年是不是都12月才開一次會我要跟部長提醒的啦不是開會幾次的重要性與否啦是這個功能性嘛對照韓國"},{"start":765.117,"end":779.593,"text":"人家一個國家級的一個癌症這個中心可以創造出這麼大的一個成績的效果出來降低他們癌症的死亡率降低他們致癌的這樣一個比例然後包含開發了這麼多的一個新藥"},{"start":781.189,"end":799.765,"text":"它幾乎是一個國家級的一個癌症中心它給予所有的功能於一切啦所以才有辦法去打造那個降低死亡率的目標我們要配合賴總統的健康台灣我們到2023年要降低癌症死亡率三分之一我們不能沒有積極的作為啊"},{"start":800.68,"end":822.899,"text":"一定要更多一些機器的作為嘛那我是拿韓國的例子可以做參考部長當然還是可以其他參照其他國家嘛那如果韓國的案子可以參考是不是趕快來做一些相關研究然後一個月內給委員會做一個報告那我們知道說我們要如何在2031年可以降低癌症的死亡率達到三分之一"},{"start":823.379,"end":838.768,"text":"好的 可以吧我們大概三支箭嘛第一個是癌症早期篩檢請大家民眾篩檢這個我知道 現在的篩檢也擴大了也增加了40億第二個就是癌症的基因檢測以做精準的一個治療然後"},{"start":840.009,"end":866.967,"text":"我看我們健保室每天都在公布又有什麼癌藥進來進來所以其實今年進了很多很多的癌藥對於醫師來講在治療上面真的多了很多的力氣這個大概都會都一定可以降低我們的一個五年的提升五年存活力那這個部分如果是不是說現在台灣是這樣各個醫院都已經這麼大間去那裡因為白龍有綜藝職"},{"start":869.469,"end":892.066,"text":"台大他現在資質運作 電子機也資質運作所以在台灣也許要用我們這樣的一個情況我們怎麼樣集合大家的力量是用什麼方式 這的確是可以正如委員所講的來思考但是協調整合這個是一定"},{"start":893.027,"end":920.262,"text":"都有 其實也一直這幾十年也一直有在做我知道你們都有在做但是我只是用韓國例子來講 它是2000年就要比我們在講長照日本的健康保險也是2000年開始那台灣在2000年跟2025年之間我們對防癌降低癌症死亡率都有在做這個署長也都是很記在做但是我只是講說用一個韓國例子來跟你做參考其他有其他國家的例子也都可以讓部長參考"},{"start":921.263,"end":933.585,"text":"我們要如何在這三事件已經發動的時候短短短的時間2030年現在經濟恐慌出沒四年多不是出五年 出沒四年多我們要去降到三分之一"},{"start":935.212,"end":957.41,"text":"我們會有很大很大的挑戰啊 還等到川普大帝會不會這樣會不會這樣那個藥劑我們要去因應因應嘛那剛剛聽部長講那時候我當然替這些癌友感到窩心嘛 感到溫暖嘛最起碼不能再造成他們增加這些癌症新藥的 癌症藥物的一些負擔嘛不管關稅如何去做調整嘛"},{"start":958.13,"end":981.812,"text":"其實部長講這些話 坦白講就已足夠了啦但是我們還是期待說可以達到2030年這樣的一個目標所以我才會擔憂 才會用韓國的例子來給部長做參考 給署長做參考我們來瞭解韓國他的做法然後跟我們現在台灣怎麼做 也許是有什麼我們來做一個比較 再跟委員報告分析好 最後這個是召委多給我的時間 我再講一下因為跟屏東有關係 所以要講一下"},{"start":982.552,"end":1004.602,"text":"昨天又有颱風再度掃過這個我們受災嚴重中南部嘛在風災之後登革熱就是異化的時間點我想這個大家都知道那中國現在又爆發這個屈公病那屈公病又跟這個登革熱一樣都是透過這個埃及斑蚊還有白腺斑蚊的傳染的疾病這民眾會恐慌啦那部長應該還記得2023年那時候是薛部長他為了這個事情還到雲林應該有兩趟因為那個時候"},{"start":1010.164,"end":1030.275,"text":"是從2015年來爆發最嚴重的一次將近本土確診病例登革熱的這樣的一個對象高達兩萬人左右當時嚴重到必須要封閉農民的果園消毒也造成農民在整個嚴重的經濟損失所以那一年我才跟這個"},{"start":1031.915,"end":1043.789,"text":"當地的林鄉長還有在地的一些民代跑到行政院來跟行政院做一些緩令最後行政院核定了一千八百多萬的登革熱傳染病溶損補助"},{"start":1045.356,"end":1069.872,"text":"這也算是破紀錄啦因為整個都封起來了農民沒有辦法沒有辦法去守恆嘛沒有辦法去採收嘛 對不對沒有辦法去補肥嘛沒有辦法去噴農藥嘛因為將農藥回到野外就比農藥還差一筒啊所以那組成農民的經濟損失嘛不才會去啟動來做這個步驟嘛我覺得是說因為鳳梯 丹南市 丹南零七二八現在還洋流"},{"start":1070.872,"end":1090.42,"text":"這個事後可能在很快的很短的時間內會不會造成這個登革熱還有這個區公併的區公併當然也是境外的一個防堵嘛那登革熱是有可能本土的又再起所以可能要未雨綢繆如果不積極的趕快去做相關的一些因應那到時候政府又要投入很大的人力物力甚至預算"},{"start":1091.365,"end":1105.644,"text":"所以請部長一個星期內可能一個星期還太久我覺得因為洋流已經過了嘛所以我們從風災來之前都一直在做宣導"},{"start":1106.385,"end":1131.917,"text":"同時也督導地方的衛生局在環境的清潔上面特別要注意到登革熱的相關的疫苗的一個預防那也 氣功病其實也是沒有人傳播他也不會人傳染所以是一樣的啦也是要清到 循道清刷一樣去把它落實啦希望就不要避免到對人民更進一步的傷害好 謝謝了 謝謝部長 謝謝署長主席請站起來 謝謝"},{"start":1135.202,"end":1136.474,"text":"謝謝你講了十分鐘啊"}]}}},"gazette":{"lineno":906,"blocks":[["劉委員建國：（12時35分）召委辛苦，請坐。有請部長。"],["主席：請邱部長。"],["邱部長泰源：召委好。"],["劉委員建國：部長，美國總統川普在8月5日接受媒體採訪的時候有公開表示會先對藥品課一個小關稅，在一年到一年半之間稅率將提高到150%，然後會再提高到250%，也因此他希望藥品要在他們美國國內生產。川普大帝隨便講一句話，即便還沒有發生，都還沒有發生就造成全球大混亂，因為他的這些話，果不其然，全球的藥廠開始緊張，因此召委今天再排一次會，我在4月其實就已經排過一次了，你看蘇召委多用心，然後也緊張這個事情，所以才再排這一次的專報，邀請大家一起再一次來討論。針對這個議題我特別關心，因為在本月11日又有一篇報導，部長，請看一下，這篇報導大致上就是說，藥廠為了維持利潤，可能會把成本轉嫁到其他國家，全球藥價都會飆漲，漲幅恐怕超過兩成，有癌症病友就透露，大家現在很焦慮，因為光是一年的自費藥物就百萬起跳，如果藥價再漲，半年可能就要多花50萬，恐怕難以負荷。還有癌友的三大憂慮，請部長再看一下。第一，已經自費用藥的癌友，如果藥價再持續上漲，那癌友恐怕就難以負擔。第二，如果癌藥漲價，目前已經在健保給付中的癌藥，會不會有重新議價或退出的問題？第三，對於可能準備納入健保的癌藥，會不會因為這一波的關稅衝擊而最終變成無法納入？部長有掌握嗎？"],["邱部長泰源：好，謝謝召委的關心，這的確是我們政府應該努力的。我們現在追求癌症的標準化死亡率在2030年要降低三分之一，怎麼樣給病人最好的早期篩檢，然後適當、精準的基因檢測，然後精準的治療，其實是很需要藥物的，我相信我們政府，尤其是衛福部這邊，一定全力以赴，不管是在健保或自費的支付方面，一定不要去增加癌友的負擔，這是一個最大的原則。"],["劉委員建國：一定不要去增加癌友的負擔，面對到關稅的衝擊，哪怕關稅調到150%、250%，就是不能讓癌友增加這些藥物費用的負擔，對不對？"],["邱部長泰源：我想我們一定要以這個做為最大的原則。"],["劉委員建國：好，OK。好，謝謝。署長要不要補充？署長很嚴肅。"],["石署長崇良：這個衝擊真的是滿大的，未來到底會走到什麼程度，我們會密切注意，不過我們有盤點，如果全球的藥價都一起漲的時候，我們受到的最大衝擊會是還在專利期內的藥，其他的藥都還有議價空間，可是專利期內的藥通常寡占性比較強，所以我們首先盤點在專利期內的藥還有多少項，以健保來講，還有214項左右是屬於專利期的藥，專利期內的藥現在健保的支出大概一年在390億左右，這裡面屬於基本也就是必要藥品的大概是75項左右，健保支出大概是200億，所以我們在短期內當然會需要多一點經費來挹注，以因應萬一調漲的時候我們比較沒有議價空間，就只好多付出一些。","第二個，這一些專利的藥在未來五、六年內大概有76個品項會過專利期，所以我們要鼓勵針對過專利期的藥要趕快用學名藥或生物相似藥來替代，這樣藥價就會比較低。因此，我們也有一個鼓勵的措施，如果在過專利期的五年內提出學名藥或生物相似藥，我們就讓它前兩張的價格與原廠藥一樣，藉此分散用藥的風險，這是第二個。第三個就是學名藥的鼓勵，因為其中還是有很多會是學名藥，所以我們也鼓勵學名藥，去年是先從生物相似藥開始，今年我們就鼓勵癌症的化學藥、也鼓勵學名藥，採取獎勵的措施，明年開始會將所有癌症用藥的學名藥都納入獎勵，我們就這樣一步一步來因應。"],["劉委員建國：我給予足夠的時間讓署長這樣一一的說明，對不對？你已經占了我一半的質詢時間，請主席要補回來給我。","言而總之、總而言之，我聽的就是部長那句話，無論美國的關稅如何調整、對藥價的關稅如何調整，總而言之、言而總之，不能讓我們的癌友因為關稅調整造成更大的負擔，我要聽的就是這句話。但還是要有相關的一些因應作為及配套，簡單講，無論是150%或250%，衛福部應該儘速針對癌症、罕病及重症這三項類別提出藥品別、治療線別及病類別可能受到的衝擊進行評估及領域調查，我認為這個應該要做吧？"],["邱部長泰源：這個一直都在做，但是因為川普的政策一直都有變化，所以我們也會隨著他的政策去做調整。"],["劉委員建國：OK。"],["邱部長泰源：如果有必要的話，隨時都可以做相關的報告。"],["劉委員建國：因為川普的政策一直都有變化，所以你們做相關的調查也必須跟著變動，這個我也很清楚，但我還是要建議部長，主動監控癌症、罕病及重症的藥品價格波動，緊密追蹤國內藥品價格是否受國際因素影響而提高，並隨時提出相關的因應措施，避免市場訊息不對稱造成恐慌性的加價，這樣可以吧？"],["邱部長泰源：當然，應該要這樣做。"],["劉委員建國：應該要這樣做？"],["邱部長泰源：是。"],["劉委員建國：你們有這樣做嗎？你們有隨著川普政策的變動而做這樣的市場監控嗎？應該沒有吧？"],["邱部長泰源：食藥署要不要回答一下？不好意思！又要用你的時間。"],["劉委員建國：好，已經超過四分之三了，主席會補給我。"],["姜署長至剛：針對藥品進行監控的話，我們的製劑要2至3個月，如果在半年前製劑已經發生短缺，在通報系統上通報，我們會啟動整個藥學會的評估，在必要時我們可以做專案的進口、專案的輸入以及藥品的調控。接下來其實是更進一步，根據藥事法第二十七條之二第三項，不見得只針對必要的藥品，而是在所有藥品短缺的情況之下，需要有一個進入調配的機制，政府能夠進一步的介入。關於這個部分，目前我們希望能夠用智慧導入的系統……"],["劉委員建國：署長，我請教部長的是針對價格的部分，但你回應我的是針對一旦缺乏這些藥品時該如何輸入，對不對？我是針對價格的部分啊！"],["姜署長至剛：關於自費藥品價格的部分，其實食藥署這邊沒有特別的訂價權責，我們是針對……"],["劉委員建國：你的意思是部長找你上來答復我就不對了嗎？他找錯人了？"],["姜署長至剛：自費其實是……"],["邱部長泰源：我想自費的藥品對這些急重症與罕病病人也是很大的負擔……"],["劉委員建國：對啊！"],["邱部長泰源：站在政府的立場，這個一定要監測，不能讓他們的負擔隨意被增加，因此，請藥廠不能隨意加價，也不要有造成恐慌的加價現象。"],["劉委員建國：請部長向委員會做一個說明，你們的監測機制應該是在因應美國關稅的過程中馬上啟動，適時地公布這些相關的訊息。"],["邱部長泰源：好，我們馬上啟動機制來監控價格的波動。"],["劉委員建國：謝謝。","第二個題目，剛剛部長答復我的時候表示，我們要追求至2030年將癌症致死率降至三分之一，對不對？但是從長遠來看，我覺得臺灣必定要儘速扶植國家的生技產業，這個部分絕對不只是衛福部的事，而是要經由跨部會的合作，包含經濟部及國發會等等。我想現在要鼓勵國外大型藥廠來臺灣投資設廠也很困難了，因為美國希望這些藥廠能去美國設廠，才會給予關稅免除的優惠。既然我們不用去鼓勵他們來臺灣設廠，相對的，你們就要大肆針對國內藥廠給予相關獎勵或鼓勵措施，降低我們對於國外藥廠的依賴。為什麼我會這麼講？其實衛福部應該不只可以扶植民間的藥廠，甚至還有能力可以進行整合，對不對？像是投入開發等等，這些都可以做。"],["邱部長泰源：當然。"],["劉委員建國：以韓國為例，它在2000年成立國家癌症中心，不僅整合國內癌症的各項業務，也包含臨床的治療研究等項目，最重要、最重要的是它本身也有研發癌症藥物的能力，至今已經自主研發多項抗癌新藥，涵蓋免疫療法、標靶藥以及能量代謝抑制劑。從南韓的媒體數據資料來看，南韓癌症的整體死亡率，從2002年到2013年，年年均下降至2.8%，2013年至2021年已經下降到3.2%。同時對比臺灣年齡標準化的癌症死亡率，2024年臺灣每10萬人就有大約113人死於癌症，而南韓大約是61人，還不到我們的一半，差不多一半啦！如果按照南韓的人口數對比起來，可以說是少之又少喔！天下雜誌在2022年有一個專題報告是在探討韓國做了什麼，因為他們在20年前做了一個決定，如今罹癌率及死亡率都比臺灣低。在這個報告的開頭就講，韓國的癌症發生率及死亡率都低於臺、日，5年存活率更高達70%，背後的關鍵就是在2000年成立國家癌症中心，這是天下雜誌的報導，提供給部長參考。"],["邱部長泰源：是。"],["劉委員建國：也就是有資源、有預算，還有整個政策的支持，人家的成果就是如此，他們的國民也不必擔心藥價會不會漲，不會太過於擔憂。如果對照臺灣，我們現在只有行政院的中央癌症防治會報以及國衛院的癌症研究所，對不對？"],["邱部長泰源：是。"],["劉委員建國：部長，你有參與行政院的中央癌症防治會報嗎？"],["邱部長泰源：有。"],["劉委員建國：一年開幾次會？"],["邱部長泰源：應該至少每半年開一次會。"],["劉委員建國：有嗎？"],["邱部長泰源：有，我們都有參加。"],["劉委員建國：應該是沒有吧？根據我的資料，從111年到113年這三年都只有在12月開一次會。"],["邱部長泰源：最近一、二年有開會。"],["劉委員建國：主持單位應該是國健署與健保署，再加上國衛院轄下的癌症研究所，在場應該有國健署與健保署的同仁，可以問他們，這三年是不是都是在12月才開一次會。我要提醒部長，重點不是在於開過幾次會，而是在於它的功能性。"],["邱部長泰源：是。"],["劉委員建國：對照韓國，人家一個國家級的癌症中心，可以創造出如此斐然的成績，降低他們的癌症死亡率、降低他們的罹癌率，也包含開發了這麼多的新藥。它幾乎是一個國家級的癌症中心，集所有的功能於一身，才有辦法打造降低死亡率的目標。我們要配合賴總統的健康臺灣，到2030年要降低癌症死亡率三分之一，所以我們不能沒有積極的作為，一定要有更多的積極作為嘛！我是拿韓國的例子給你參考，當然部長也可以參照其他國家的做法，如果韓國的例子可以參考，是不是就趕快進行相關的研究，1個月內向委員會提出報告，讓我們知道如何在2030年降低癌症死亡率至少三分之一，可以吧？"],["邱部長泰源：我們大概就是三支箭，第一個是癌症早期篩檢，請民眾參與篩檢，而且我們也將篩檢項目擴大，並增加了40億。第二個就是癌症的基因檢測，藉此進行精準的治療。此外，我們健保署每天都會公布又有什麼新的癌藥進來，其實今年進了很多很多的癌藥，對醫師而言，在治療上真的增加了很多的利器，這些一定都可以提升我們的5年存活率。現在臺灣各家醫院都蓋得那麼大間，譬如北榮的重粒子癌症治療中心、臺大癌醫也正式啟用質子治療設備、以及長庚的質子治療，因此在臺灣是要思考如何集合大家的力量、採用什麼方式，誠如委員所講的，這個的確是可以思考，不過，協調、整合一定都有，在這幾十年來其實一直也都有在做。"],["劉委員建國：部長，我知道你們都有在做啦！我也只是舉韓國的例子來講，它是從2000年開始做，又譬如我們講的長照，日本的介護保險也是從2000年開始，其實臺灣在2000年到2022年之間對於防癌及降低癌症死亡率也都有在做，署長也都是很積極在做，而我只是舉韓國的例子給你參考，就像其他國家的例子也都可以讓部長參考嘛！我們要如何在這三支箭已經發動之後，短短的時間耶！現在已經是2025年，距離2030年只剩四年多了，不是剩下5年耶！只剩下四年多，我們要如何讓它降到三分之一，可以說是很大很大的挑戰。更何況，又碰到川普大帝不確定的政策變動，我們該如何因應藥價的問題？剛剛聽到部長講的一席話，我當然也替癌友感到窩心、感到溫暖，最起碼不能再增加他們在癌症藥物上的負擔，無論關稅如何的調整。坦白講，部長講的這席話就已經足夠了，但我們還是期待可以達成2030年的目標，所以我才會擔憂、才會舉韓國的例子給部長參考、給署長參考。"],["邱部長泰源：我們會去了解韓國的作法，與目前我們臺灣的做法進行比較，之後再向委員提出分析報告。"],["劉委員建國：好。最後，利用召委多給我的時間再講一下，因為與屏東也有關係，所以要講一下。昨天楊柳颱風再度掃過受災嚴重的中南部，在風災之後就是登革熱易發的時間點，我想這是大家都知道的事，再加上中國現在又爆發屈公病，它與登革熱一樣都是透過埃及斑蚊及白線斑蚊傳染的疾病，所以民眾會感到恐慌。","部長應該還記得2023年那時的薛部長為了這個事情還去雲林兩趟，因為那是自2015年以來爆發最嚴重的一次，本土登革熱確診病例高達2萬人左右。當時嚴重到必須封閉農民的果園進行消毒，也造成農民嚴重的經濟損失，因此那一年我與當地的林鄉長及在地的一些民代前往行政院反映，最後行政院核定一千八百多萬的登革熱傳染病農損補助，也算是破紀錄了。因為整個都封起來，農民沒辦法巡園、沒辦法採收、沒辦法施肥、沒辦法噴農藥，況且登革熱的藥也比農藥的毒性更重，當然就造成農民的經濟損失，因此才會啟動農損補助。","我的意思是之前有丹娜斯颱風、有0728的豪雨、現在又有楊柳颱風，之後在很短的時間內會不會造成登革熱及屈公病的傳播？屈公病當然是在於境外的防堵，但登革熱有可能在本土又再起，所以必須要未雨綢繆，如果不積極進行相關的因應，到時候政府又要投入很大的人力、物力、甚至是預算，所以請部長於1個星期內，其實我覺得1個星期都太久，因為楊柳颱風在上禮拜已經過境……"],["邱部長泰源：我們在風災來之前都一直宣導，同時也督導地方的衛生局，在環境清潔上要特別注意登革熱的相關預防。其實屈公病也是藉由媒蚊傳播，並不會人傳人，一樣也是要落實「巡、倒、清、刷」，避免對人民造成更進一步的傷害。"],["劉委員建國：好，謝謝部長。"],["邱部長泰源：謝謝。"],["劉委員建國：主席，請站起來，謝謝。"],["主席：你已經講20分鐘了，謝謝！謝謝部長。","本日會議詢答全部結束，委員楊曜、涂權吉所提書面資料列入紀錄，刊登公報。"],["委員楊曜書面質詢：","壹、美國擬調藥品稅率至250%，衛福部是否已盤點受衝擊產業並與經濟部研議因應對策？","問題：綜合外電報導，八月初時，美國總統接受媒體專訪時表示，接下來針對進口藥品的關稅稅率可能高達250%，美國總統川普表示：「我們將先對藥品課徵一個較少的初始關稅，但在1年、1年半內，稅率最高會調升至150%，然後再調到250%，因為我們希望藥品能在美國生產。」又經濟部今年1月的新聞稿指出，113年醫療器材業出口值達25.4億美元，按出口地區觀察，以美國為我國出口的最大市場（占29.7%），又經濟部去年資料顯示，我國製藥產業112年出口值為18億美元，也以美國為我國出口的最大市場（占39.8%），請教衛福部，在美國關稅政策影響下，衛福部是否已盤點受衛福部監督管理之產業，受衝擊產業清單並與經濟部研議因應對策來協助業者？","貳、國外保健食品進口我國，其稅率財政部研議分階段調降，如何確保其食安？","問題：今年三月時媒體報導，財政部表示，保健食品進口稅率30%，研議分年、分階段逐步調降，為降低我國保健食品產業衝擊，經濟部則建議，對國內製造端，應適度鬆綁國內食品管理相關法規等，對此，衛福部在確保食安的前提下，如何建立制度來完善的產業經營環境？","參、美國關稅政策影響，街福部如何確保藥品及國產學名藥供應穩定？","問題：據健保署統計，2023年健保申請的藥費逾2,400億元，其中國產學名藥約占459億，請教衛福部，先前因COVID-19疫情的影響下，我國藥物供應穩定確實也受到一定程度的影響，依健保署資料，藥費約八成給付於進口原廠藥及學名藥，顯示我國藥物供應仰賴進口的程度相當高，易受國際經貿情勢的影響，在近期美國關稅政策影響下，衛福部為確保藥品供應穩定，衛福部做了哪些因應措施？再者，為降低我國藥品供應仰賴進口，確保我國健保用藥供應穩定，提高學名藥的產能也是方式之一，衛福部及健保署在去年11月預告修正《全民健康保險藥品價格調整作業辦法》、《全民健康保險藥品給付項目及支付標準》等辦法，規劃健保藥價政策改革方案，請教衛福部，修法重點為何？修正後辦法預計何時上路？而相較於一般疾病，罕病患者用藥的選擇替代性低，若罕病用藥遭遇漲價或缺藥的狀況下，衛福部因應措施為何？此外，由於美國關稅政策影響各供應鏈，可能導致萬物齊漲，113年我國醫療器材業進口總值38.3億美元，自美國進口最多，其中以輻射及電子醫學設備、檢測試劑為最大進口貨品，若上述產品價格提高，導致醫院成本增加，是否成本轉嫁至民眾，導致就醫費用提升？衛福部如何因應？"],["委員涂權吉書面質詢：","近年來，國際藥品市場波動與關稅政策調整，對我國藥品供應、產業競爭力及健保財務均帶來挑戰。根據財政部統計，2022年至2024年間，我國藥品進口總額約每年900億至1,000億元新台幣，主要進口來源之一即為美國。倘若美方對我國輸入藥品關稅提高至150%-250%之間，將對我國藥價、供應鏈、健保財務造成重大衝擊。","一、藥品關稅對民生的影響","藥品進口成本上升，勢必反映在藥價，健保未給付項目與自費用藥價格將直接增加，導致癌症、罕病患者及慢性病用藥負擔加重。以2024年我國自費藥市場規模約1,100億元計算，若藥價上漲20%，民眾每年需多負擔約220億元。更嚴重者，一旦關稅衝擊造成藥廠減少供貨，恐發生藥荒，重演去年永豐輸液短缺之亂，直接危及病人安全。請問衛福部，是否已規劃「緊急進口免稅」或「關稅衝擊下的藥品供應保障計畫」？在缺藥時，如何優先保障民眾用藥權益，避免出現延誤治療的陣痛期？","二、藥品關稅對產業的影響","台灣藥品製造業雖有一定基礎，但高端藥品、專利藥高度仰賴進口。關稅調升將削弱國內經銷與製藥商的競爭力，也可能讓跨國藥廠延後新藥在台上市時程。根據經濟部工業局2023年報告，國內製藥產業出口值約400億元新台幣，若國內市場價格與供應環境惡化，產業投資意願將下降，恐影響未來創新研發與國際合作。請問財政部，是否有針對藥品關稅調整進行風險評估？有無與衛福部合作，針對特定藥品類別採取差別稅率或減免機制？","，三、藥品關稅對健保財務收支與百億癌藥基金政策的影響","健保年度藥品支出約佔總醫療費用四分之一（2024年約1,550億元）。進口成本增加將直接推高健保藥價，壓縮其他醫療服務預算，進一步增加健保財務壓力。尤其「百億癌藥基金」每年定額25億元，若藥價因關稅上漲20%，基金在相同預算下的受惠人數將減少約五分之一，等同每年少服務近500名癌症病人，除非追加預算或與財政部協調關稅減免。請問衛福部，是否已完成關稅衝撃對健保與百億癌藥基金的情境模擬？一旦發生衝撃，是減少受惠病人數、增加預算，還是啟動關稅免除？","藥品關稅議題關係到人民健康權、產業穩定性與健保永續性。衛福部與財政部必須超前部署，提出跨部會完整配套，包括關稅談判策略、國產藥扶植計畫、健保財務預警機制及基金保障方案，避免關稅衝撃在藥價、供應與財務間形成惡性循環，最終由病人承擔代價。"],["主席：現在作以下決定：第一，報告及詢答完畢。第二，委員質詢未及答復或請補充資料者，相關機關於2週內以書面答復，委員另要求期限者，從其所定。","本日會議到此結束，現在散會，謝謝大家。","散會（12時55分）"]],"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"}}}