An Inside Look at the First AI-Prescribing Technology

In April of 2026, the state of Utah launched a pilot program allowing artificial intelligence (AI) to handle routine patient prescription renewals.¹ Since then, companies like Nolla Health have capitalized on this novel opportunity through the regulatory approval of its Nolla Derm application.²

“[Nolla Health] has become the first organization in the country to receive regulatory approval for AI to issue initial prescriptions,” announced the company in an October release. “Starting in Utah through its Nolla Derm app, Nolla's system will prescribe acne prescriptions to help patients better access dermatology care without a waitlist, office visit, or unaffordable bill.”

With this revolutionary announcement in pharmacy, leaders across the industry have expressed both excitement and concerns regarding this immense step in health care technology.

To help quell said concerns, while also highlighting the unique opportunities Nolla Health is introducing in the health tech space, Zaid Fadul, MD, FS, FAAFP, chief medical advisor with Nolla Health and overseeing physician for its Nolla Derm application, joined us for this week’s episode of Drug Topics’® Over the Counter podcast.

Rigorous Guardrails and Multistage Physician Review

During the podcast, Fadul details how the Nolla Derm application operates within strict clinical boundaries rather than functioning as an open-ended prescriber.²

The system relies on a detailed intake history of past over-the-counter and prescription medications, medical backgrounds, diagnostic progression, and a 5-angle facial scan to generate personalized morning and evening treatment plans for acne vulgaris. Rather than improvising, the software selects treatments exclusively from predefined algorithms created by dermatologists and a Harvard-trained Mohs surgeon.^2,3

Patients experiencing severe acne, complex symptoms, or pregnancy fall outside these clinical protocols and are redirected immediately to human clinicians.

To establish regulatory confidence, Nolla Health collaborated with the Utah Office of Artificial Intelligence Policy and the Utah Medical Board to build a structured governance model. Before launching the pilot, the underlying model was trained on close to 2 million dermatology images and demonstrated a 96% clinical agreement rate across 10,000 test cases.^2,3

In the first stage of the Utah pilot, Fadul and another licensed physician independently evaluate and certify every single AI-generated prescription prior to patient release. If evaluating physicians disagree with a recommendation, they adjust the drug strength before releasing the order. Subsequent stages will transition to autonomous prescribing with daily retrospective audits for 500 cases, followed by weekly sampling of at least 10% of cases, backed by independent third-party auditors to guarantee transparency.

This automated framework aims to address severe care access bottlenecks across Utah, where an estimated 100,000 residents suffer from active acne while facing an average wait time of 61 days for specialist appointments. Eleven counties in the state currently lack a practicing dermatologist.^2,3

By managing low-acuity acne presentations for just $4.99 per month, the application attempts to address persistent health care deserts.²

Essential Pharmacist Oversight and the Future of Care

Despite automated diagnosis capabilities, community pharmacists remain the indispensable final safeguard in this new digital workflow. Fadul emphasizes that pharmacists occupy a vital position at the point of care, where patients frequently seek guidance on skin-care regimens, sunscreen pairings, application techniques, and potential product interactions.³

Although automated systems like Doctronic refill platforms and Nolla Derm transmit prescriptions electronically, dispensing pharmacists perform face-to-face clinical evaluations that software cannot replicate. Pharmacy experts point out that pharmacists can review total medication records and assess vital signs, such as monitoring blood pressure for lisinopril renewals, providing key safety checks before dispensing.^1,3

National health organizations and pharmacy leaders advocate for clear legal liability guidelines, transparent data auditing, and preserved human clinical touchpoints as state licensing authorities draft permanent rules for AI prescribing. Fadul notes that automated prescribing is intended to eliminate tedious administrative tasks and repetitive workload for health care staff, enabling clinicians and pharmacists to dedicate more time to complex patient cases and meaningful clinical counseling.

He concluded that although AI integration will transform medicine over the next decade, adopting these systems requires a cautious, incremental approach to safeguard public health and preserve clinical trust.

Stay tuned for weekly podcast episodes of Over the Counter powered by Drug Topics. Check out our most recent episode with Allison Schneider, MPH, who discussed pharmacies’ ongoing MFP cash flow crunch and how independents are faring alongside shifting PBM and 340B landscapes.

REFERENCES

1. Gallagher A. Utah launches pilot program for AI chatbot to renew prescriptions. Drug Topics. April 23, 2026. Accessed November 4, 2026. https://www.drugtopics.com/view/utah-launches-pilot-program-for-ai-chatbot-to-renew-prescriptions

2. Nolla Health announces nation's first AI to issue initial prescriptions. Nolla Health. News Release. October 5, 2026. Accessed November 4, 2026. https://www.prnewswire.com/news-releases/nolla-health-announces-nations-first-ai-to-issue-initial-prescriptions-302897659.html

3. Nowosielski B, Fadul Z. AI prescribing pilot places pharmacists as final link in care. Drug Topics. November 2, 2026. Accessed November 4, 2026. https://www.drugtopics.com/view/ai-prescribing-pilot-places-pharmacists-as-final-link-in-care