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委員林月琴等18人擬具「藥事法部分條文修正草案」案。(八) 委員郭昱晴等16人擬具「藥事法部分條文修正草案」案。(九) 委員王鴻薇等18人擬具「藥事法部分條文修正草案」案。(十) 委員邱鎮軍等20人擬具「藥事法部分條文修正草案」案。(十一) 委員林倩綺等18人擬具「藥事法部分條文修正草案」案。(十二) 委員陳菁徽等16人擬具「藥事法部分條文修正草案」案。二、審查(一) 行政院函請審議「藥害救濟法第三條及第二十八條條文修正草案」案。(二) 委員羅廷瑋等16人擬具「藥害救濟法第三條條文修正草案」案。(三) 委員劉建國等16人擬具「藥害救濟法第三條及第二十八條條文修正草案」案。(四) 委員王正旭等19人擬具「藥害救濟法第三條及第二十八條條文修正草案」案。(五) 委員林月琴等18人擬具「藥害救濟法第三條條文修正草案」案。(六) 委員郭昱晴等16人擬具「藥害救濟法第三條及第二十八條條文修正草案」案。(七) 委員王鴻薇等18人擬具「藥害救濟法第三條及第二十八條條文修正草案」案。」(八) 委員邱鎮軍等19人擬具「藥害救濟法第三條及第二十八條條文修正草案」案。(九) 委員林倩綺等18人擬具「藥害救濟法第三條及第二十八條條文修正草案」案。(十) 委員翁曉玲等17人擬具「藥害救濟法第三條條文修正草案」案。【第一（十一）及二（九）案，如未經各黨團簽署不復議同意書，則不予審查；第一（十二）及二（十）案，如未經院會交付本會審查或未經各黨團簽署不復議同意書，則不予審查】【綜合詢答】）","transcript":{"pyannote":[{"speaker":"SPEAKER_00","start":0.92534375,"end":1.6172187500000001},{"speaker":"SPEAKER_00","start":2.07284375,"end":9.919718750000001},{"speaker":"SPEAKER_02","start":4.82346875,"end":5.39721875},{"speaker":"SPEAKER_02","start":9.71721875,"end":11.269718750000003},{"speaker":"SPEAKER_00","start":11.505968750000001,"end":14.340968750000002},{"speaker":"SPEAKER_02","start":12.450968750000001,"end":12.585968750000003},{"speaker":"SPEAKER_02","start":12.771593750000001,"end":12.923468750000001},{"speaker":"SPEAKER_02","start":14.138468750000001,"end":19.33596875},{"speaker":"SPEAKER_00","start":17.96909375,"end":18.45846875},{"speaker":"SPEAKER_00","start":19.33596875,"end":19.825343750000002},{"speaker":"SPEAKER_00","start":20.06159375,"end":20.399093750000002},{"speaker":"SPEAKER_02","start":23.60534375,"end":24.17909375},{"speaker":"SPEAKER_02","start":27.55409375,"end":74.29784375},{"speaker":"SPEAKER_02","start":75.15846875000001,"end":76.64346875000001},{"speaker":"SPEAKER_03","start":78.53346875000001,"end":98.39534375000001},{"speaker":"SPEAKER_03","start":98.69909375,"end":113.34659375000001},{"speaker":"SPEAKER_02","start":107.84534375000001,"end":107.98034375},{"speaker":"SPEAKER_02","start":112.18221875,"end":112.60409375},{"speaker":"SPEAKER_02","start":113.44784375,"end":121.34534375000001},{"speaker":"SPEAKER_03","start":121.71659375,"end":122.84721875000001},{"speaker":"SPEAKER_02","start":121.75034375000001,"end":121.95284375000001},{"speaker":"SPEAKER_02","start":123.35346875,"end":124.50096875000001},{"speaker":"SPEAKER_02","start":124.85534375,"end":136.58346875},{"speaker":"SPEAKER_02","start":137.74784375000002,"end":146.05034375},{"speaker":"SPEAKER_03","start":146.67471875,"end":157.35659375},{"speaker":"SPEAKER_02","start":156.76596875,"end":159.29721875},{"speaker":"SPEAKER_03","start":159.29721875,"end":159.93846875},{"speaker":"SPEAKER_03","start":160.64721875,"end":166.06409375},{"speaker":"SPEAKER_02","start":166.26659375,"end":169.69221875000002},{"speaker":"SPEAKER_02","start":170.40096875,"end":173.67471875},{"speaker":"SPEAKER_03","start":174.94034375,"end":183.56346875},{"speaker":"SPEAKER_02","start":174.99096875,"end":175.10909375},{"speaker":"SPEAKER_02","start":184.28909375,"end":195.57846875},{"speaker":"SPEAKER_03","start":194.65034375000002,"end":195.37596875},{"speaker":"SPEAKER_03","start":195.73034375,"end":213.38159375},{"speaker":"SPEAKER_02","start":213.83721875,"end":216.04784375000003},{"speaker":"SPEAKER_02","start":217.21221875,"end":217.76909375000002},{"speaker":"SPEAKER_02","start":218.03909375,"end":220.89096875},{"speaker":"SPEAKER_03","start":221.66721875000002,"end":222.96659375000002},{"speaker":"SPEAKER_02","start":222.88221875000002,"end":223.48971875},{"speaker":"SPEAKER_03","start":223.48971875,"end":225.32909375000003},{"speaker":"SPEAKER_03","start":225.85221875000002,"end":226.32471875000002},{"speaker":"SPEAKER_03","start":227.59034375000002,"end":231.25221875000003},{"speaker":"SPEAKER_03","start":233.58096875,"end":235.06596875000002},{"speaker":"SPEAKER_03","start":235.89284375000003,"end":240.33096875},{"speaker":"SPEAKER_02","start":239.63909375000003,"end":252.24471875},{"speaker":"SPEAKER_02","start":252.73409375000003,"end":253.02096875},{"speaker":"SPEAKER_03","start":252.78471875000002,"end":253.29096875000002},{"speaker":"SPEAKER_02","start":253.51034375,"end":256.39596875},{"speaker":"SPEAKER_03","start":257.13846875,"end":264.61409375},{"speaker":"SPEAKER_02","start":262.04909375,"end":267.82034375},{"speaker":"SPEAKER_03","start":268.29284375000003,"end":270.73971875},{"speaker":"SPEAKER_02","start":270.46971875,"end":273.79409375},{"speaker":"SPEAKER_03","start":273.30471875,"end":277.20284375},{"speaker":"SPEAKER_02","start":273.96284375,"end":275.14409375},{"speaker":"SPEAKER_02","start":277.94534375,"end":278.28284375000004},{"speaker":"SPEAKER_02","start":278.67096875000004,"end":279.14346875},{"speaker":"SPEAKER_02","start":279.51471875000004,"end":284.29034375000003},{"speaker":"SPEAKER_02","start":284.40846875,"end":298.11096875000004},{"speaker":"SPEAKER_02","start":298.36409375,"end":301.95846875},{"speaker":"SPEAKER_02","start":302.51534375,"end":310.48034375000003},{"speaker":"SPEAKER_02","start":311.18909375000004,"end":335.21909375},{"speaker":"SPEAKER_02","start":335.82659375000003,"end":347.60534375000003},{"speaker":"SPEAKER_02","start":348.14534375,"end":362.89409375},{"speaker":"SPEAKER_02","start":362.97846875000005,"end":371.60159375},{"speaker":"SPEAKER_02","start":372.14159375,"end":373.82909375},{"speaker":"SPEAKER_03","start":373.91346875000005,"end":377.99721875},{"speaker":"SPEAKER_03","start":378.55409375000005,"end":384.73034375000003},{"speaker":"SPEAKER_03","start":385.37159375000005,"end":405.57096875},{"speaker":"SPEAKER_02","start":400.89659375,"end":402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因為沒有人可以問 只有你可以問而已不好意思 那我們就不休息 請黨團的助理聯絡一下所以我問到不休息對 你可以 看你可以怎樣問好 謝謝主席 那個麻煩請我們衛福部次長還有食藥署署長委員好"},{"start":27.888,"end":50.847,"text":"兩位好缺藥跟缺原料是全球共同的問題本席也很高興在疫情過後衛福部有相當正視這個問題所以食藥署在2024年1月31號的時候就已經發布了藥品供應監測系統而且已經上線啟用當然主要的目的"},{"start":51.327,"end":76.327,"text":"是為了要持續強化主動監測跟協調藥品妥善分配確保藥品穩定供應那因此針對這個系統本席有幾個問題要請教那當初這個藥品供應的監測系統呢最初鎖定參與的這個對象是哪些那大概全台全台有幾家"},{"start":78.798,"end":98.103,"text":"跟委員這邊做進一步說明我們當初希望能夠是供應端的能夠知道所以第一件事情就是我們相關的盤商盤商其實是協助把藥品送到醫療院所等等的這個過程當中所以這是一塊我們現在能夠精準的比較掌握的"},{"start":98.763,"end":121.118,"text":"那我們持續的希望他能夠除了這以外我們目前在藥物韌性計畫裡面能夠把更多的資訊能夠導入所以我們有一個叫做藥物智慧導入的邏輯的以及存熱的系統所以那個供應端大概基本上就是包括這個大型藥廠啦還有這些大型的裝盤商等等"},{"start":121.832,"end":145.471,"text":"目前有14家那因為當初一開始參與的時候我們接到的資訊是大型中盤商的加數你們當初發布的時候一開始只有12家那現在有14家了那這樣子的但在我們全台就是你有統計過我們有多少的大型藥廠跟多少的大型中盤商"},{"start":148.348,"end":173,"text":"對 針對這個議題謝謝委員我們就想盡辦法在進口商的部分是另外一部分我們能夠知道也希望能夠在醫院端能夠取得對啊 那你有沒有統計過大約的數據這個大型的大概都已經包含在裡面但是有一部分的其實是我們要持續在溝通的當中好 那如果說好幾百我這樣子的這樣子的估計有這麼多嗎"},{"start":175.046,"end":183.052,"text":"而那是藥廠的部分我們在盤商的部分其實是大型的盤商在比較確立的是比較集中那目前是這樣子的狀況"},{"start":184.729,"end":213.23,"text":"對那所以不是因為你們既然有這個監測系統我竟然問不出大概起碼就是說那有多少是不方便透露是嗎委員我們大概是從後面的量藥品的劑量大概是接近九成的量八到九成的涵蓋量就是說我們沒有涵蓋每一家但是整體在健保系統裡面的供應的量大概涵蓋有八到九成但中間還是有需要努力的地方"},{"start":214.088,"end":230.598,"text":"對 所以我還是聽不太懂就是那個量 你的量大概有多少你說實際的加數對啊加數的部分我這就 請問一下中本山14家是在裡面還有其他什麼加數"},{"start":233.709,"end":256.161,"text":"還有社區藥局的東西我想這個部分是還沒有完全涵蓋這是委員是很精確的所以如果連社區藥局都是的話那我問你加速應該我想你們要做這個監測系統最起碼基本的這些加速數據你們應該要很精確的掌握吧所以我說好幾百應該也不過分"},{"start":257.228,"end":278.791,"text":"跟委員報告因為這些藥局其實都是靠盤商送去的我理解所以你如果可以很具體告訴我盤商有哪些盤商目前我們是涵蓋了14家盤商所以你說14家有涵蓋率90%80%到90%的所有的健保的使用藥物好那"},{"start":282.346,"end":308.259,"text":"這個平台的運作方式我先記住你剛剛講的涵蓋率80%到90%這個平台的運作方式是由合作大型中盤藥商每天將藥品庫存資料借接導入我用大型中盤藥商基本上是根據你們的新聞稿"},{"start":308.999,"end":332.587,"text":"的文字那就是這個具備這個查詢介面然後供這個職業的藥事人員查詢所需藥品然後於這個合作中盤藥商之供應情形那將有助這個基層藥局及診所取得所需的藥品來保障民眾用藥的權益那這裡面的問題是"},{"start":335.908,"end":362.067,"text":"大型的醫療院所它所需求的藥品可能跟這個基層藥局的診所不太一樣像剛剛講因為藥局畢竟我們都比較可以垂手可得那他們負責的可能是直接就大型醫療院所負責的可能是直接跟這個嚴重疾病或者是涉及生命安全的藥品有關那跟民眾的用藥是不太一樣的"},{"start":363.428,"end":384.041,"text":"所以是不是這個系統對於這個大型醫療院所用的這個藥實際上並沒有監測到或者監測不足這個部分委員其實講得非常精準我們針對有一塊醫院裡面的所謂的藥品的部分我們採用的方式是"},{"start":385.482,"end":405.027,"text":"希望能夠在健保的部分使用量能夠借階能夠知道它實際上的我們需要的是它的量的走勢那至於我們在社區藥局裡面還是有一大部分比例特別是我們連續處方籤的一些所謂的代謝性疾病的使用高血壓糖尿液等等所以這個部分是有可能是重複一點點"},{"start":406.047,"end":411.35,"text":"就是說對我們這個監測我從我開始質詢到現在我一直聽到監測這個量這個量但對於我們這個藥品"},{"start":416.638,"end":442.365,"text":"的這個種類或類別的這個藥品其實我們比較可以看到的是他的量所以那個大型醫院所提供的藥品必要藥品跟我們一般在藥房可以取得的或使用的其實這個就有一些差別了我想這個部分會不會就有疏漏到"},{"start":442.925,"end":463.938,"text":"或者您說的也重疊到跟委員先報告就是說在藥品供應上面來講其實我們一直要求就是比較大型的醫療院所它其實跟相關的藥品廠商這邊它的契約是非常重要的一件事因為它這邊的契約才能夠穩定的持續供應這些大型醫療院所它量比較大或者是某些剛剛委員提到的"},{"start":464.258,"end":489.759,"text":"某些比較特定的藥品他自己跟藥廠之間的契約來確保他的合約供應那再來剛剛提到我們這個中間這個系統事實上在盤商這邊事實上是協助包含比較中小型或者是我們的這一個基層的藥局去確保他們這邊的運作能夠有一定程度的供應當然是這兩個部分對這個我理解因為那確實你們這個新聞稿大概我想我提問大概也依據你們發布的訊息來提問那"},{"start":492.162,"end":510.056,"text":"我們換一個角度來看就是說我們如何來鼓勵這個藥廠的參與參與這個藥品存量的通報畢竟就是說每日通報的人事行政成本是不低的"},{"start":510.777,"end":532.786,"text":"那甚至呢這個可能還有這個校期的問題啊政策沒有說明清楚啦等等那就是說他行政成本不低以外那你們到底有沒有誘因那政府對於這個藥商通報的正確性好像也沒有那個立場去苛責嘛我不曉得你們的看法是什麼"},{"start":534.597,"end":551.359,"text":"報告委員 針對現在我們需要的希望能夠可靜性所以是採用電腦拋接的形式讓它的行政成本能夠以最低的行政成本能夠達到這樣的效果第二個部分是對於藥商裡面假如是不可苛責 比如說傳奇"},{"start":552.961,"end":571.365,"text":"比如說他的航班等等的重大的事件之下我們也會有一些免除的條款可是這些系的辦法在這一次修法的大架構底下呢還會有執法的一些辦法我們會繼續的延伸那個我這樣問好了你們對於就是說目前的通報狀況你們滿意嗎"},{"start":574.802,"end":597.774,"text":"報告報告委員我們目前對於藥品出現異常的時候需要做進一步分析的我們只要接到之後我們從實在署內以及我們跟協辦的臨床的藥學會裡面對於特定藥品就可以積極的去研析完做後續是否有替代的或者是真的有需要需要進口專案進口我再換個問法好了就是說"},{"start":601.756,"end":624.271,"text":"在像這些盤商其實我的理解有一些沒有參與的盤商他們可能不是不願意參與是因為他們有疑慮他們對於這個政策上沒有說明的很清楚所以就有些就沒有來參與我們樂見於就是說全台的這些盤商都一起來參與這個"},{"start":626.913,"end":648.984,"text":"對 我們非常非常希望他們共同參與其實資料越完整對於我們對任性的部分建立我覺得是更好的那我們對於互相的權利義務的部分我們不會是完全是在單方面的其實委員 之前委員也有特別提到我們希望是雙方去協調能夠達到資訊我們希望的是資訊上面能夠對接之後達到最好的涵蓋效果"},{"start":649.529,"end":668.32,"text":"對 所以我在這裡也是提醒就是說因為我們這個政策的發布截至今天為止我們其實理想上可以達到百分百的通報但是還沒有我想這一段的差距你們要找出原因 找出誘因去解決它"},{"start":669.641,"end":696.314,"text":"那另外就是說根據這個食藥署的發布聲明我們這次是由這個中華民國藥師公會全國聯合會他們一肩扛起來主責尋求這個合作的這個中盤藥商來參與通報那事實上呢大型的這個藥商可能具有研發生產製造那他們的成員呢並不是以這個執行藥師業務為主體的藥商那反而他們的藥品可能都是直接"},{"start":697.795,"end":716.928,"text":"與這個大型醫療院所的這個採購那這些大型的藥商直接相關的可能是健保合附的這個藥價那今天呢很可惜我們石部長沒有來因為部長他擔任過食藥健保署的署長他一定非常清楚那真正的27條之2的必要藥品"},{"start":718.148,"end":742.194,"text":"事實上實際上它才是最應該被監測的藥品單靠食藥署的職權我相信你們是很難做到就是很即時有效的監測需要健保署在核定藥價的同時考慮提供一點差別性的誘因讓這些大型藥商有積極參與的態度願意配合食藥署的監測系統"},{"start":746.355,"end":770.072,"text":"那畢竟就是說我剛剛前面有提這個監測這個系統它的譬如說監測對 講到這些大型的藥商因為我們剛剛一直在講監測藥品監測藥品但是沒有原料就沒有藥品那我們是不是如果在與其我們在監測這個藥品的同時我們是不是應該對於這個大型藥廠我們應該監測的是原料"},{"start":775.22,"end":801.205,"text":"有的原料不是在國內那我們當然自己國內的原料藥這邊我們跟國內的原料藥但你要製造的時候你有需求要製造的時候委員其實這就是幾個部分跟委員報告第一個是國內的原料藥廠商我們這邊其實已經對接上來我們也積極在協助我們自己國內的藥廠可以使用自己國內原料藥這是第一個部分那第二個部分有些藥廠其實現在全世界各國他們大概60%的原料藥都來自於印度或中國"},{"start":802.345,"end":823.926,"text":"所以這也是我們要強化國內韌性的其中每個國家都有這個問題那他們如果是來自其他國家或甚至來自某些單一國家的話那這也是為什麼我們這次請這些藥廠他們在供藥可能會出現半年內供藥可能會出現波動的這種情況要事先讓我們知道他假設因為他的原料供應有問題導致他的藥品不能生產這要提早讓我們知道讓我們來做相關的因應"},{"start":824.967,"end":841.386,"text":"跟委員進一步說一點補充那我們對於要求原料要他們的儲備其實我們有要求到半年的一個儲備期就是的量所以這部分事實上能夠在製造的過程中原料能夠盡量能夠不予愧缺"},{"start":842.046,"end":861.423,"text":"因為我想在整個我們在這裡盤點然後再通報再監測那當然這個衍生會衍生一些成本因為畢竟很多的大型醫療院所甚至他們如果這個藥的效期不到一年或一年半他們是拒收的"},{"start":862.083,"end":890.662,"text":"那所以我想在藥房的部分其實也是一樣所以這個通報或者我們接下來進一步有要求一個相當時間的一個庫存的時候我想都會衍生當然會衍生一些譬如說這個倉儲的成本或冷鏈的成本甚至一些人事盤點的成本那我想這個部分還有一種成本就是說就是這個銷毀的成本"},{"start":892.363,"end":907.313,"text":"那如果有這個庫存料那但我們後來沒有沒有如期去用到的時候他也必須要銷毀所以這樣的成本都必須要被考量進去那這些成本呢還有我們的"},{"start":907.873,"end":927.098,"text":"政府的配套其實都在影響到我們的就是國內的這些盤商參與通報系統的很多這些原因那所以這個部分本席特別今天在這裡也提出來希望你們可以一併的去做檢討考慮然後讓這個整個"},{"start":931.261,"end":946.348,"text":"讓大家的這個參與度可以再更積極一點那我想這個藥品監測他一定是不會層級的這個議題不是三級機關的問題喔所以這個部分我不曉得兩位有沒有同意我的看法"},{"start":947.54,"end":967.873,"text":"好那再回到我們今天討論的藥事法修訂因為很多的提案他都涉及的必要藥品供應跟掌握通報還有因應機制事實上呢就是但我們我們到底有沒有真的盤點到這些大型醫院的必要藥品"},{"start":968.913,"end":996.066,"text":"這個部分我們可能也要好好去想一想事實上很難有一套好的通報系統是由立法院可以規範完全的因為通報系統的含掛率跟時效是檢驗系統最重要的兩大指標法律上只能管制但是法律不是誘因的工具"},{"start":997.026,"end":1014.686,"text":"所以要滿足這兩大指標還是要靠衛福部規劃出誘因來讓這個涉及藥品涉及這必要必要藥品的大型廠商來主動通報那剛剛也提過這個通報所增加的成本所以"},{"start":1016.389,"end":1043.961,"text":"衛福部你們應該有這個要有單位負責每日監控通報訊息然後提早做出反應那這樣子呢我們的必要的這個藥品存量才能正確有效的被監測那我們民眾的這個用藥的健康需求才能真的被保障那我想我們如何進一步來規劃提升這個系統的通報誘因我不曉得本席剛剛提了幾個具體的建議你們"},{"start":1045.882,"end":1064.779,"text":"是不是能夠接受然後回去我們回去了解一下相關各剛提到的這些廠商他們還有什麼樣的需求我們來協助那其實我想我們也逐漸來走向就是自動化數位化的方式來做管理降低大家的相關的管理成本好因為那個我相信次長在辦公室"},{"start":1066.52,"end":1087.48,"text":"大家會得到很多單位的訊息回報但是有時候或許實際上在執行面是有一些狀況或者需要改進的空間那也未必坐在辦公室就可以了解到我們都很積極參加學協會的相關活動大家都可以直接溝通得到好 那我等下也在這邊就我了解到的跟你們分享了好 謝謝謝謝委員"}]}},"supported_relations":[],"relations":[]}