Utah allows AI to prescribe acne drugs without doctor visit

In a first for a U.S. state, Utah is allowing an AI system to issue prescriptions without a doctor authorizing each one, starting with acne medications, HealthDay and the Los Angeles Times reported. Nolla Health, based in New York City, launched the service for Utah patients on Oct. 5. The pilot is limited to eight topical acne products, not oral drugs.

Using Nolla's app, a patient photographs their face and completes a medical history, the Los Angeles Times reported. The app then assesses skin oiliness, grades acne severity from clear to severe, compares that with the medical history, selects a topical treatment, and sends the prescription to a pharmacy. Ordinarily, only a physician, certain nurse practitioners, or a physician assistant can write prescriptions; Utah has waived that sign-off for this pilot, but each prescription still carries a clinician's name even though no clinician actually writes it, Nolla CEO Luis Wenus told the Los Angeles Times.

For the first 100 patients, a doctor will review each prescription before it is sent. For the subsequent 400 patients, the AI may prescribe independently, with a physician reviewing those prescriptions on a weekly basis later. From then on, a physician will randomly check at least 10% of prescriptions each month. Nolla was the first company to present its plan to the Utah Medical Licensing Board before winning approval, and a doctor selected by that board will supervise the prescription reviews, according to the LA Times. The current pilot runs for one year with a possible two-year renewal.

Wenus said acne creams and gels are low-risk, with possible side effects like redness, dryness or peeling, and some ingredients are available without a prescription. "The possible adverse reactions are just much, much lower risk than many other drugs," he said. An in-person dermatology appointment typically costs between $150 and $300; Nolla's app charges roughly $5 per month, and the customized topical formulations cost about $50 monthly.

John Whyte, MD, who heads the American Medical Association, said in an interview with the Los Angeles Times that AI tools can assist but should not independently practice medicine. "If they are, then they need to be held to very high standards, just as humans are," he said. "And I don't think they can meet that burden."

Healthcare Dive reported that Utah's Office of Artificial Intelligence Policy also approved pilots for two other companies. August AI's pilot would use artificial intelligence to renew prescriptions for chronic conditions, while Expect Fitness would provide virtual pelvic floor therapy for issues like urinary incontinence, pelvic pain, and post-childbirth problems. Both companies still need written regulatory approval before reducing human oversight.

Earlier, Utah allowed Doctronic to use AI to renew existing prescriptions, prompting criticism from the Utah Medical Licensing Board, which said it had not been consulted and warned the pilot endangered residents; the state kept the program but removed two drugs from its list.