The world’s first government-approved AI prescribing trial is on a path to expansion. If you think pharmacists prescribing isn’t a good idea, you may have to reset your expectations.
Utah’s agreement with Doctronic – the company whose AI has been trialling autonomous prescribing since late 2025 – expires this month, and all indications are the state will renew and other states in the US will start joining in.
Utah’s Office of AI Policy has just approved five new AI healthcare agreements, signalling that the state has no intention of pulling back.
The October 5 expansion – reported by Becker’s Hospital Review – adds Nolla Health, which uses AI to issue initial acne prescriptions without a physician visit; August AI, approved for chronic medication renewals covering frontline treatments for diabetes, blood pressure and cholesterol; and umbrella frameworks for Intermountain Health and the University of Utah Health that create expedited review pathways for future AI pilots.
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That brings the total to four active companies operating across different corners of the prescribing landscape: chronic disease renewals, psychiatric medication refills, and now de novo acne prescribing. The medications list across all programs now runs to roughly 200 drugs.
In the trial’s published results AI recommended renewal in 72% of cases, and physicians agreed with its decisions 91% of the time.
In the 28% of cases it escalated to a human, physicians judged nearly a third of those escalations unnecessarily cautious – the AI erring on the side of safety rather than overreach. No serious safety incidents have been reported.
Utah’s Medical Licensing Board objected early on in the trial, with 11 members calling for suspension and arguing that prescription renewals were never truly routine – a patient’s condition may have changed since their last visit.
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The American Medical Association agreed. Public Citizen backed the call for suspension and the FDA has pointedly noted it has not authorised any AI chatbots to prescribe.
Notwithstanding, liability in the event of an AI error remains unresolved.
According to Doctronic it is in talks to expand to Arizona, Missouri, Texas and Wyoming. Its co-founder has predicted a dozen states will follow in 2026.
The political logic driving the trial isn’t that far off the Australian government’s commitment to pharmacist prescribing.
Australia is running its own version of the same argument: workforce pressure, access in underserved areas, cost. And just like the US it’s the state governments that are going to the bleeding edge.
NSW, South Australia and the Northern Territory have all expanded pharmacist prescribing rights this year, with the federal government broadly supportive.
The RACGP has called it a slap in the face. Eight out of 10 GPs believe the government is not listening to them on the subject.
Australian GPs are being asked to accept human substitution dressed up as reform, but Utah’s physicians at least retain nominal oversight of what the AI decides.
Utah’s trial, with clinicians still in the loop, feels a more rational approach to the problems GPs see in trying to replace GPs with pharmacists.
