Starting Monday, Utah adults can open an app, scan their face, and walk away with a prescription for acne medication that no doctor directly reviewed. Nolla Health says its Nolla Derm app will begin issuing those prescriptions without direct human oversight, a shift the company is billing as a first for the country.
The rollout, limited strictly to acne medications, lets Utah residents 18 and older sign up for $4.99 a month, according to a Nolla Health announcement. Patients complete informed consent, a 10- to 15-minute questionnaire and a face scan before the system generates a treatment plan, per the same release. Bloomberg reports the launch marks the first time a state has allowed this kind of technology to replace the role of a doctor.
According to the Los Angeles Times, Nolla's AI analyzes a patient's skin, identifies acne problems, rates oiliness and generates a numerical severity score ranging from clear skin to severe acne. The app then recommends medication from eight approved topical treatments, and the Los Angeles Times reports the company submits those AI-generated prescriptions directly to pharmacies in Utah. The program excludes pills and hormone therapies, limiting itself to topicals that, according to the Nolla Health team as cited by the Los Angeles Times, carry adverse effects limited to localized skin irritation or dryness.
How the Review Process Is Staged
Nolla's pilot unfolds in three stages, per the Los Angeles Times: the first 100 patients' prescriptions go through physician review before reaching a pharmacy, the next 400 patients' prescriptions are submitted by AI with weekly retrospective physician review, and beyond that, a physician reviews at least 10% of prescriptions issued each month. The Utah Department of Commerce's AI Division approved the pilot, which includes a third-party physician appointed by the medical board to oversee prescription reviews, the Los Angeles Times reports. The program runs for one year and may be renewed for two additional years at the discretion of the Utah Office of Artificial Intelligence Policy.
Per the prnewswire release, the AI can only select between pre-approved treatment pathways and is designed to route patients to a licensed physician whenever it cannot confidently choose a treatment. Nolla Health also says licensed clinicians agree with its treatment recommendations in more than 96% of real-world cases, though that figure comes from the company itself. Headquartered in New York, Nolla says it operates across 44 states, with Utah now serving as the proving ground for autonomous prescribing.
A Narrower Fix Than Doctronic's Troubled Pilot
Nolla's launch follows a rockier chapter in Utah's AI health care experiment. The state previously allowed residents to get prescription refills through an AI chatbot called Doctronic, a program that, according to CNN, processed 30-, 60- or 90-day renewals for medications already prescribed by licensed physicians. CNN reports that during the program's initial phase, human doctors reviewed all refill orders, though the company expected to soon transition to fully automated refills, and that the refill program was overseen by a five-member board of AI specialists, none of whom were doctors.
That arrangement drew formal pushback. The Utah Medical Licensing Board wrote an open letter, per the Los Angeles Times, saying it had not been consulted and that the Doctronic decision placed Utah citizens at risk, and Utah News Dispatch reported the board called for the program's immediate suspension. During the first five months of that pilot, the AI system recommended prescriptions for renewal in 72% of cases, and reviewing physicians agreed with those recommendations 91% of the time, according to Fierce Healthcare. The Utah Office of Artificial Intelligence Policy later removed two medications from Doctronic's approved list, the Los Angeles Times reports.
Nolla Health says it engaged the Utah Medical Licensing Board before its own authorization, and attorney Zachary Boyd said Utah gave the company a narrow exception, according to the Los Angeles Times. Utah waived the law requiring a prescriber to be a licensed physician for this pilot, and the state's AI policy office required special malpractice insurance covering AI-generated prescriptions while building duty-of-care provisions into Nolla's contract, the paper reports. Nolla Health co-founder Luis Wenus told the Los Angeles Times that the company's prescriptions carry the name of a clinician without a human professional actually writing them, and he argued that topical treatments carry much lower possible adverse reactions than many other drugs.
Cost, Access and the Industry's Pushback
Wenus has framed the push as one of affordability. A typical dermatology visit runs $150 to $300, the Los Angeles Times reports, compared with Nolla's roughly $5 monthly app fee or its compounded medications priced around $50 a month. The Utah pilot is targeting an estimated 5,500 to 11,000 acne patients who seek dermatological care each year, according to the same reporting, and Nolla says it aims to make dermatological care more broadly affordable and accessible before expanding beyond acne — with Wenus describing plans to eventually turn the company into an AI-driven personal doctor for families.
Not everyone in organized medicine is on board. American Medical Association CEO John Whyte said AI tools should not autonomously practice medicine, the Los Angeles Times reports, a position that echoes broader concerns the American Medical Association has raised about transparency and reliability in health AI. The AMA has said long-term validation of AI's full impact on patient outcomes remains undetermined, and that evidence-based care and transparency need to stay at the forefront as these tools spread. Politico has described Utah's broader experiment as a high-stakes test of whether AI can safely take on one of health care's most sensitive tasks — and whether patients and policymakers will trust it. CNN notes that Utah isn't alone in loosening the rules, reporting that Texas and Wyoming are also waiving restrictions on AI in health care.
