What if an AI system could decide whether you need an acne prescription without a doctor approving every prescription? New York-based digital health startup Nolla Health is putting that idea to the test in Utah, where its AI system will evaluate patients and issue initial prescriptions for certain acne treatments.
The pilot, launched under Utah's regulatory AI sandbox, is one of the more notable US tests of AI moving beyond assisting doctors to taking on part of the prescribing process. For now, however, the programme is limited to low-risk acne cases and still includes human physician oversight at several stages, according to media reports.
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The service is available to Utah residents aged 18 and older through Nolla's Derm app, which costs about $4.99 a month. Patients complete a 10- to 15-minute medical questionnaire and upload facial images. The AI evaluates the images and medical information, determines an acne severity score and generates a treatment recommendation and prescription.
The program is limited to adults with mild-to-moderate acne and a physician-approved list of topical medications, including certain topical retinoids and antibacterial treatments. Oral drugs, systemic medications, hormone therapies and isotretinoin, commonly known as Accutane, are excluded. Cases that fall outside the system's criteria or raise concerns are referred to a human doctor.
The pilot will expand in phases. During the first 100 prescriptions, licensed physicians will review every prescription before it reaches a pharmacy. For the next 400 cases, prescriptions can be issued through the AI system, with doctors conducting retrospective reviews. Once the program moves beyond 500 prescriptions, physicians will review a defined sample of cases each month, along with cases escalated because of uncertainty or other concerns.
Nolla says the service could reduce the cost and access barriers associated with conventional dermatology. The company charges roughly $5 a month, while compounded treatments may cost around $50 a month. The initiative also aims to address limited access to dermatologists, with proponents pointing to long appointment waits and the relatively small share of acne sufferers who receive specialist care.
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This has raised concerns among doctors and medical organisations about the safety of AI diagnosing patients and prescribing medicines without a doctor directly involved. Nolla says its system agreed with doctors in more than 96% of cases during its internal tests.
Utah's AI sandbox gives the company limited regulatory flexibility to run the pilot. It does not mean the state has approved or certified Nolla's technology.
Acne treatment is only the first step for Nolla. The company wants to eventually build an AI system that can handle a much wider range of medical decisions. The Utah pilot will show whether that model can work safely when AI is allowed to prescribe treatment, with doctors still overseeing the process.
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