{"error":false,"id":["165347"],"data":{"IVOD_ID":165347,"IVOD_URL":"https://ivod.ly.gov.tw/Play/Clip/1M/165347","日期":"2025-11-13","會議資料":{"會議代碼":"委員會-11-4-26-10","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","屆":11,"會期":4,"會次":10,"臨時會會次":null,"種類":"委員會","委員會代碼":[26],"委員會代碼:str":["社會福利及衛生環境委員會"],"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":"2025-11-13T09:28:19+08:00","結束時間":"2025-11-13T09:40:03+08:00","影片長度":"00:11:44","支援功能":["ai-transcript"],"video_url":"https://ivod-lyvod.cdn.hinet.net/vod_1/_definst_/mp4:1MClips/fffa2c65c610face0187a1bd37ef1df18ff38efa2589ba08bff109ec81674948ad4d19330d4f164e5ea18f28b6918d91.mp4/playlist.m3u8","委員名稱":"陳昭姿","委員發言時間":"09:28:19 - 09:40:03","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。\n\n(討論事項)\n審查\n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。\n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。\n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。\n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。\n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。\n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。\n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。\n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。\n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。\n十、委員蘇巧慧等30人擬具「癌症防治法修正草案」案。\n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。\n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。\n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。\n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。\n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。\n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。\n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。\n【專題報告及討論事項綜合詢答；討論事項僅詢答】）","transcript":{"pyannote":[{"speaker":"SPEAKER_02","start":1.95471875,"end":7.72596875},{"speaker":"SPEAKER_02","start":8.181593750000001,"end":11.978468750000001},{"speaker":"SPEAKER_01","start":9.379718750000002,"end":9.919718750000001},{"speaker":"SPEAKER_02","start":12.29909375,"end":26.60909375},{"speaker":"SPEAKER_01","start":12.332843750000002,"end":13.193468750000001},{"speaker":"SPEAKER_01","start":28.617218750000003,"end":36.68346875},{"speaker":"SPEAKER_02","start":30.91221875,"end":32.430968750000005},{"speaker":"SPEAKER_02","start":36.58221875,"end":36.666593750000004},{"speaker":"SPEAKER_02","start":36.68346875,"end":36.73409375},{"speaker":"SPEAKER_01","start":36.73409375,"end":36.80159375},{"speaker":"SPEAKER_02","start":36.80159375,"end":80.03534375000001},{"speaker":"SPEAKER_01","start":81.21659375,"end":85.78971875},{"speaker":"SPEAKER_02","start":85.60409375,"end":134.98034375},{"speaker":"SPEAKER_01","start":87.56159375,"end":88.52346875},{"speaker":"SPEAKER_01","start":89.48534375,"end":89.85659375},{"speaker":"SPEAKER_03","start":136.60034375,"end":158.23409375},{"speaker":"SPEAKER_00","start":149.71221875,"end":150.20159375},{"speaker":"SPEAKER_02","start":156.63096875000002,"end":157.22159375},{"speaker":"SPEAKER_02","start":158.23409375,"end":184.30596875},{"speaker":"SPEAKER_03","start":158.25096875,"end":158.79096875000002},{"speaker":"SPEAKER_02","start":184.47471875000002,"end":215.37284375000002},{"speaker":"SPEAKER_02","start":215.89596875,"end":244.27971875000003},{"speaker":"SPEAKER_02","start":244.46534375000002,"end":253.61159375000003},{"speaker":"SPEAKER_02","start":254.08409375000002,"end":318.61409375},{"speaker":"SPEAKER_02","start":319.12034375,"end":327.54096875000005},{"speaker":"SPEAKER_02","start":327.97971875,"end":353.07284375},{"speaker":"SPEAKER_01","start":353.24159375000005,"end":379.26284375},{"speaker":"SPEAKER_02","start":374.70659375,"end":375.02721875000003},{"speaker":"SPEAKER_02","start":375.31409375000004,"end":376.59659375},{"speaker":"SPEAKER_02","start":377.50784375,"end":380.61284375},{"speaker":"SPEAKER_01","start":380.61284375,"end":388.42596875000004},{"speaker":"SPEAKER_02","start":386.58659375,"end":388.62846875},{"speaker":"SPEAKER_01","start":388.62846875,"end":392.05409375000005},{"speaker":"SPEAKER_02","start":390.09659375,"end":396.30659375000005},{"speaker":"SPEAKER_01","start":393.16784375000003,"end":393.47159375},{"speaker":"SPEAKER_01","start":394.66971875,"end":395.58096875},{"speaker":"SPEAKER_01","start":396.30659375000005,"end":405.50346875},{"speaker":"SPEAKER_02","start":398.66909375,"end":400.03596875000005},{"speaker":"SPEAKER_02","start":401.30159375000005,"end":410.46471875000003},{"speaker":"SPEAKER_01","start":406.02659375,"end":408.38909375000003},{"speaker":"SPEAKER_01","start":410.05971875,"end":451.03221875},{"speaker":"SPEAKER_02","start":427.59284375000004,"end":428.60534375000003},{"speaker":"SPEAKER_02","start":429.14534375000005,"end":430.84971875},{"speaker":"SPEAKER_03","start":430.84971875,"end":430.86659375000005},{"speaker":"SPEAKER_02","start":432.46971875,"end":433.02659375},{"speaker":"SPEAKER_02","start":433.43159375000005,"end":434.15721875},{"speaker":"SPEAKER_02","start":434.32596875,"end":435.27096875},{"speaker":"SPEAKER_00","start":436.09784375000004,"end":436.11471875},{"speaker":"SPEAKER_02","start":436.11471875,"end":436.51971875000004},{"speaker":"SPEAKER_02","start":444.50159375000004,"end":445.69971875000005},{"speaker":"SPEAKER_02","start":449.42909375000005,"end":452.77034375000005},{"speaker":"SPEAKER_01","start":451.13346875,"end":458.55846875000003},{"speaker":"SPEAKER_02","start":458.00159375000004,"end":464.09346875000006},{"speaker":"SPEAKER_01","start":458.72721875,"end":459.08159375},{"speaker":"SPEAKER_01","start":459.80721875,"end":462.82784375000006},{"speaker":"SPEAKER_01","start":463.21596875,"end":474.75846875},{"speaker":"SPEAKER_02","start":467.38409375000003,"end":468.43034375},{"speaker":"SPEAKER_00","start":468.43034375,"end":468.46409375},{"speaker":"SPEAKER_02","start":470.23596875000004,"end":472.41284375000004},{"speaker":"SPEAKER_01","start":475.11284375,"end":483.97221875},{"speaker":"SPEAKER_02","start":476.54721875,"end":478.74096875000004},{"speaker":"SPEAKER_02","start":480.12471875000006,"end":481.27221875000004},{"speaker":"SPEAKER_02","start":481.86284375,"end":530.73284375},{"speaker":"SPEAKER_01","start":489.86159375000005,"end":489.91221875},{"speaker":"SPEAKER_00","start":489.91221875,"end":489.92909375000005},{"speaker":"SPEAKER_00","start":508.71096875,"end":508.96409375},{"speaker":"SPEAKER_01","start":530.3447187500001,"end":531.8972187500001},{"speaker":"SPEAKER_02","start":531.25596875,"end":549.7509687500001},{"speaker":"SPEAKER_01","start":535.2722187500001,"end":537.9384687500001},{"speaker":"SPEAKER_01","start":538.17471875,"end":538.27596875},{"speaker":"SPEAKER_01","start":549.29534375,"end":556.29846875},{"speaker":"SPEAKER_02","start":551.53971875,"end":552.3159687500001},{"speaker":"SPEAKER_02","start":556.0959687500001,"end":557.96909375},{"speaker":"SPEAKER_02","start":558.54284375,"end":559.4709687500001},{"speaker":"SPEAKER_01","start":558.6609687499999,"end":562.4072187500001},{"speaker":"SPEAKER_02","start":560.9053437499999,"end":588.68159375},{"speaker":"SPEAKER_02","start":589.08659375,"end":590.8247187500001},{"speaker":"SPEAKER_02","start":590.8415937500001,"end":591.9890937499999},{"speaker":"SPEAKER_00","start":592.3940937500001,"end":597.76034375},{"speaker":"SPEAKER_00","start":598.3172187499999,"end":606.8897187499999},{"speaker":"SPEAKER_02","start":605.6240937499999,"end":632.67471875},{"speaker":"SPEAKER_00","start":608.22284375,"end":608.2397187500001},{"speaker":"SPEAKER_02","start":633.09659375,"end":643.4240937500001},{"speaker":"SPEAKER_02","start":644.18346875,"end":645.61784375},{"speaker":"SPEAKER_00","start":645.07784375,"end":653.2959687499999},{"speaker":"SPEAKER_02","start":651.25409375,"end":651.2878437500001},{"speaker":"SPEAKER_02","start":652.24971875,"end":657.86909375},{"speaker":"SPEAKER_00","start":653.61659375,"end":654.0890937500001},{"speaker":"SPEAKER_00","start":656.14784375,"end":668.7365937500001},{"speaker":"SPEAKER_02","start":667.80846875,"end":690.3872187500001},{"speaker":"SPEAKER_02","start":690.89346875,"end":697.32284375},{"speaker":"SPEAKER_00","start":694.8928437500001,"end":695.8884687500001},{"speaker":"SPEAKER_02","start":700.69784375,"end":703.8703437500001}],"whisperx":[{"start":4.618,"end":26.406,"text":"謝謝主席 有請史部長我先幫您升官了 趙偉我們在談今天主席之前我想先跟你談一下藥品政策我們兩個都在醫藥界耕耘的非常久我想請問你當一個國際的新藥成功研發上市的時候您覺得台灣都是第幾波引進的"},{"start":28.649,"end":51.583,"text":"过去大概都在第三波左右但是最近我们有一些药已经可以赶上第二波甚至第一波了答案是第三波没有错但是总共也只有四波这个是很遗憾根据台美生技协会的研究台湾是全球GDP第14大经济体但却不是国际药厂他们的首选"},{"start":52.263,"end":57.064,"text":"這個原因當然很多 包括市場小新藥價格偏低 而且還綁了還款協議全球的參考價格會有連鎖效應還有冗長的核價過程我想這些我過去也都質詢過市場小是既定的事實但是我們應該把可以掌握的變數把它做好國際普遍都有所謂的溢價還有藥價差問題但是台灣的藥價差連年擴大我想請問部長這兩年的藥價差是多少"},{"start":81.5,"end":102.786,"text":"現在有在縮小大概差不多在500億左右對啦 部長至少這兩年都700億我們可以再去是很佔藥費很龐大的比率那對新藥引進是莫大的不穩定性雖然說今天我們談到狠藥跟癌藥有公務預算來預注但是就是說對引進的廠商還是有顧慮"},{"start":104.046,"end":107.668,"text":"這個前端價格即便看似合理那中間我們其實還要經過這個還款協議 很多的溢價過程後端還有一個要價差所以健保署說我們增加了預算那其實對他們不是很有感 因為那個錢不會變成一個實收啦"},{"start":119.714,"end":134.736,"text":"這是為什麼台灣要進到第二波很難啊那個部長大概不能拿一兩個案子來處理更別說第一波那我知道這個已經啟動藥品改革政策會議那我想請陳書長你簡單用幾句話說你目前的進度跟方向是什麼"},{"start":136.88,"end":162.67,"text":"委員報告我上任的時候也拜會過委員在這個藥品政策關於drug price gap就藥品政策的藥價差的部分在做縮小那目前也依循時部長在署長任內的政策在今年四月份我們事實上修了兩個法那第二個部分是關於這個醫院跟這個藥品的這個drug price gap這藥價差的部分目前還是謝謝署長因為我很謝謝建保署總算承認有這三個字叫藥價差"},{"start":163.63,"end":188.837,"text":"那藥價他面對他就有金額 真的非常龐大 700億然後超過700億 而且一直在增高不管你怎麼砍藥價 越來越高那這個是一個很大的問題那網路上也有部長 那暫時先謝謝署長部長 你前兩週對於補充保費網路上有很多討論其實我覺得健保長期存在一個問題是民眾 醫藥界 還有政府三方對政策的理解有很大落差"},{"start":189.897,"end":214.862,"text":"所以很多民眾提出了什麼呢政府不該給付罕病藥物 等一下我會講為什麼裡面每天都說是天價另外就說應該提高部分負擔還有政治人物 我先不說他的名字他說部分負擔要提高到200%那就是完全不懂的人才會講出這個話部分哪有200%所以我們都清楚政策的怎麼設定但是民眾不見得理解所以我要講的說新聞常常看到"},{"start":215.982,"end":242.027,"text":"健保納入天價藥品這個標題有點像那個健保署的大內宣那民眾人都不會有疑問 既然健保都要破產那你為什麼這麼貴的藥要納進來呢但事實上健保署會跟廠商進行什麼價量協議嘛 分期支付嘛等等 而且像圖上這個含藥這個新聞跑出來說這個牌價大概是1億但是我們知道經過這個"},{"start":244.648,"end":254.657,"text":"加量協議分期支付甚至有效果財富嘛這個最終的支付價格其實沒這麼高上次那個第一個基因藥品想說4900萬其實沒付那麼多啦部長我們大家都心知肚明"},{"start":259.901,"end":273.548,"text":"但是民眾不知情啊民眾不知情也不會知道這個是由另外一個基金喊要的一個上次我們通過那兩個就所謂天價都是喊要事實上是專款支付啊不會影響其他病人的疾病的這個治療的權益嘛"},{"start":275.049,"end":291.935,"text":"所以我是認同部長你講的說全台灣每個人捐五塊錢不到就可以救一個小朋友 寒病小朋友這些都絕對值得但是我們要讓民眾了解健保的價值這需要社會溝通所以我在跟部長在提醒前健保署李博張署長也指出"},{"start":293.216,"end":316.789,"text":"這個個別總額醫院個別總額實施以後醫院可能不願意禁藥我們知道罕藥是專款我們知道可是對個別醫院總額是可以排除在這不是一般的這個服務費但是因為罕藥價我們又回到藥價差了藥價差有限因為它的管理保存跟處理可能相對是比較更多的精力跟時間那對醫院而言利潤不夠"},{"start":319.25,"end":323.272,"text":"所以他不願意進藥 所以現在已經傳出中部大型醫院 我想你聽過已經用我們藥局沒有備這個藥為由拒絕罕病病人然後把他推到其他醫學中心表示他也是醫學中心所以我想請問署長或部長兩個問題請問你有沒有監控使用高價罕藥救的個案把它轉到別的醫院就診的情況那第二個問題是你有去做各個醫院"},{"start":346.822,"end":367.376,"text":"收治新確診的個案自然的成長跟它歷史的資料比較嗎這兩點就請回答 謝謝好 謝謝委員對我們這個藥品政策相當的熟悉啦那我三點的補充說明第一個我們剛剛提到這些很高價的罕藥事實上我們也都是經過這個醫療科技評估去評估它確實有這個價值那我們才納入所以這並不是說這個"},{"start":376.081,"end":399.473,"text":"為了要宣傳或什麼但是那個價格出來說會怕死人啊那至於在這個但這不是事實啊這個到底我們的這個實際上的藥費是多少這個我們跟廠商之間當然你會說機密但我們很清楚對我們是不好對外去說明我想必須讓民眾知道因為你這樣會嚇到民眾然後又會覺得很困惑說無情又在乎對啊但是因為這個有這個需要Follow這個這個"},{"start":401.354,"end":408.218,"text":"在商业上对对对对对对对对对对对对对对对对对对对对对对对对对对对对对对对对对对对对对对对对对对对对对对对对对对对对对对对对对对对对对对对对对对对对对对对对对对对对对对对对对对对对对对对对对对对对对对"},{"start":428.689,"end":456.882,"text":"喊藥的藥費是排除到我們現在做的醫院個別總額之外所以不影響其他的照顧其他的病人至於剛剛您特別關切有沒有因為我們實施醫院個別總額之後而造成被病人的排擠這個我們有在監測我們有在監測我們統計的今年的4月到8月間藥商朋友最清楚他們的藥整個被送走了喊病的病人他的各個醫院的消長情形"},{"start":457.162,"end":474.322,"text":"我们都有在监测这个是很重要的监测嘛对不对有有有你的目的就整个解决一个问题又跑出别的问题有的我们就会看到说他可能有的是因为医师转了医院之后病人会跟着他走医师转那是另外一个所以每一个这个因为"},{"start":475.203,"end":481.707,"text":"不多啦 我們這四到八個月大概是一萬多個罕病的病 我們都有在追蹤你繼續追蹤好不好 我很關心這個問題那未來健保署是不是可以用白話跟大家說明啊包括這個擠負罕病的那個理由嘛那提高部分負擔的這些理論依據 相關配套可以優先用電視跟這個醫療院所"},{"start":497.616,"end":509.126,"text":"檢明圖卡來對外溝通我跟你講圖卡不是用來攻擊在野黨的圖卡是這個時候政策是非常重要的使用的才能被這個理解那個信任因為為什麼呢因為現在民眾的資料都來自電視"},{"start":513.59,"end":529.383,"text":"跟醫院但是事實上很多這不是在你們的官網嗎或是政治冗長的會議記錄可是他們不看那個啊所以當你在說明的時候你要用非常容易讓民眾明白的方式圖卡來用圖卡用的正圖是要這樣子的我們會加強這個說明"},{"start":531.485,"end":556.358,"text":"對啊 不然大家覺得很矛盾啊你自己付最高要但是事實上我很清楚 實情不是這樣他都是經過很嚴謹的評估的謝謝部長那我10月13號有質詢永豐生理鹹水的這個後續啦我還要追問 請問部長到底你對永豐的裁罰總額 總金額是多少部長你都罰了多少錢我們有去了解啦那這個案子是最後由新北市衛生局裁處了60萬元好 60萬 好 法院依據"},{"start":558.761,"end":575.145,"text":"這是根據違反藥事法裡面的GMP規定我要講的就是說為了這件事去年用了多了三四億以上今年又編了十億要穩定生理食鹽水的供應以至於不要讓準備手術的病人延後治療 耽誤治療我要請問當然署長您上來了您覺得這個裁罰基準合理嗎"},{"start":581.787,"end":597.461,"text":"結果他造成去年月年中發生嘛就多了三四億就今年又補了11億署長您覺得這個裁罰基準合理嗎要不要修罰報告委員這部分我們特別有注意到對於因為這樣子特定的廠商"},{"start":598.362,"end":618.253,"text":"他的供應的我們也希望能夠供應的範圍跟平衡能夠稍微有分攤第二個他的財閥部分我們會不是這個是先有這個問題才從外引進沒有證照的藥品嘛這個問題就是很大這是一個非常大的一個疏失啦那當然署長你要就是讓你再概括承受一下雖然不在你任內監察院報告指出指出"},{"start":619.654,"end":642.781,"text":"食藥署接貨不良品通報卻鮮少啟動無預警的查核以及在整個案件中多處缺失這個我想你看到了也就是說他認為食藥署監察院食藥署監督不力包庇廠商的意思納稅人因為要多花11億來做善後署長那你接貨不良品的你現在的SOP是什麼你的改進重點是什麼有通報至少72案"},{"start":644.577,"end":661.356,"text":"生理實驗水謝謝委員對生理實驗水因為我們的監察院報告我有看過很清楚的針對那個細節每一次的你的SOP你都清楚嗎那要改進的呢因為過去就發生了那你要改進的重點是什麼針對這部分我們監管組去做查場之後後續的"},{"start":662.077,"end":689.298,"text":"平次跟重新去掉他積極的調整的部分我們這邊已經在做了那署長今天我就是兩個問題第一個你裁罰他60萬事實上已經被檢舉很多次了就是通報了很多次不良品然後那個有感染又有雜物在那個那個等於是無菌的這個注射水裡面第二個就是說你未來接到通報如果不反應不處理這就再釀成一次大禍啊所以這兩件事情我會繼續追蹤"},{"start":691.24,"end":695.667,"text":"那也請署長 部長都多留意好 謝謝 謝謝兩位 謝謝主席好 謝謝 接下來請陳清輝委員來做詢問"}]}},"supported_relations":[],"relations":[]}