Utah has launched a pilot program that allows artificial intelligence — without physician involvement — to renew certain medical prescriptions, Politico reported Jan. 6.
The program, developed with health technology startup Doctronic, began in December and is limited to routine renewals for patients with chronic conditions. It is the first known effort in the U.S. to rely solely on AI for prescription renewals, Politico reported.
State officials said the initiative could lower costs, reduce missed medications and ease pressure on clinicians. Margaret Busse, executive director of the Utah Department of Commerce, told Politico the program also aims to support innovation by entrepreneurs whose AI tools may challenge current regulatory frameworks.
Physician groups have raised safety concerns. In a statement cited by Politico, American Medical Association CEO John Whyte, MD, said that while AI has vast potential to improve medicine, using it without physician input poses serious risks to patients and clinicians.
One concern is that patients with substance use disorders could try to manipulate automated systems to obtain medications inappropriately. Another is that AI might miss subtle clinical cues or drug interactions that a physician would catch.
Under the program, patients verify they are physically in Utah before using an online system that reviews prescription histories and asks clinical questions. If appropriate, the AI sends the renewal directly to a pharmacy. The system is designed to escalate uncertain cases to physicians, and human doctors are reviewing the first 250 prescriptions in each medication class to validate the AI’s performance. Once that threshold is met, future renewals in the class are handled autonomously.
The pilot is limited to 190 commonly prescribed medications and excludes pain management drugs, ADHD medications and injectables. Doctronic told Utah regulators its AI system matched physician treatment plans in 99.2% of 500 urgent care cases reviewed by the company, Politico reported.
Doctronic has also secured malpractice insurance that holds the AI system to the same standard of accountability as a physician. The company charges $4 per prescription renewal — a temporary fee it says may drop as the program scales, with the potential for coverage by insurers or an annual membership model.
Doctronic co-founders Matt Pavelle and Adam Oskowitz, MD, said the system is intended to increase medication access for patients with chronic conditions. Dr. Oskowitz told Politico the AI performs more checks than a typical physician visit and is “infinitely safer than a human doctor.”
The company operates a nationwide telehealth platform that routes patients to physicians following AI consultations. Mr. Pavelle and Dr. Oskowitz are in discussions with officials in Texas, Arizona and Missouri, and are considering a national regulatory pathway rather than navigating rules state by state.
Regulatory questions remain. The FDA has not taken a position on the program and declined to comment, saying the issue falls outside the agency’s regulatory purview, Politico reported. Former FDA chief counsel Lowell Schiller told Politico the agency may choose to defer to state oversight, as it has in cases like medical marijuana — or it may eventually move to bring the technology into compliance if it deems authorization necessary.
Zach Boyd, director of Utah’s artificial intelligence policy office, said the state is focused on its own regulatory responsibilities.
“Now we’re in this weird place where there are devices — maybe you could call them devices — that are purporting to practice medicine,” he said. “Our philosophy has been to just take care of our side — of the state’s authority — and the FDA is going to figure out what it’s going to figure out.”
