Since January 2026, the U.S. state of Utah has allowed an artificial intelligence system to autonomously renew prescriptions for 192 drugs used to treat chronic conditions. Early results suggest that AI could safely take over one of the most routine tasks in healthcare while saving physicians time.
The pilot is being conducted by the Utah Department of Commerce under the state's regulatory sandbox framework. Called a “regulatory mitigation agreement”, it allows innovative technologies to be tested in a controlled environment before permanent regulations are introduced.
The system, developed by AI startup Doctronic, is designed exclusively for prescription renewals. Patients must already have been diagnosed by a licensed physician, who must also have prescribed the medication being renewed.
The AI covers 30-, 60-, or 90-day refills for 192 commonly prescribed medications used to manage chronic diseases, including hypertension, diabetes, hypothyroidism, depression and hypercholesterolemia. Controlled substances are excluded, as are opioids, ADHD stimulants and injectable medicines.
The process is fully digital. Patients log into the platform, verify their identity and answer questions about their current health status. The AI reviews their medical history, checks for potential contraindications and determines whether treatment can safely continue. If no concerns are identified, the prescription is renewed electronically and sent to the patient's pharmacy.
Physician oversight remains essential
Although the system is described as autonomous, physician oversight remains essential. For each medication category, the first 250 AI renewal decisions must be reviewed and approved by a physician before the system can continue operating independently. Random audits continue throughout the pilot, and whenever the AI identifies uncertainty – such as missing clinical information, possible side effects or the need for follow-up medical tests – it automatically refers the patient to a physician. Every decision is logged and reported to state regulators.
According to Utah officials, the objective is not to replace physicians but to reduce administrative workload. State authorities estimate that routine prescription renewals account for a substantial share of medication-management activities, while delays in renewing prescriptions remain an important reason why patients interrupt long-term treatment. Poor medication adherence continues to contribute to avoidable hospitalizations and healthcare costs.
“By automating these safe, routine requests, Doctronic hopes to help doctors focus more on patient care, reduce delays, and make it easier for patients to stay on track with their medications,” according to Utah’s Department of Commerce statement.
Considerable debate
The initiative has triggered considerable debate among legal and medical experts. Researchers from Harvard Law School and commentators writing in the New England Journal of Medicine argue that even routine prescription renewals remain clinical decisions requiring assessment of a patient's current condition, potential adverse effects and, in some cases, recent laboratory results. They therefore believe autonomous AI should only be used in narrowly defined, low-risk clinical scenarios.
Others question whether systems making autonomous therapeutic decisions should require clearance from the U.S. Food and Drug Administration (FDA) as AI-enabled medical devices. Legal experts have also highlighted potential tensions with federal regulations governing who is authorized to prescribe medications.
Early results appear promising
The first outcomes from the pilot are encouraging, although researchers caution that it is too early to draw final conclusions. During the first months of operation, the AI recommended renewing prescriptions in 72% of cases, while 28% were referred to physicians because additional clinical assessment was required. For example, due to missing laboratory tests or newly reported symptoms.
Physicians agreed with the AI's renewal decisions in 91% of cases, with agreement increasing to 97% following review by a second physician. Among cases referred to doctors, clinicians considered the referral appropriate in 69% of cases, while the remaining referrals reflected a deliberately conservative approach by the AI.
Importantly, no patient safety incidents or adverse events related to the AI system have been reported so far. However, independent experts emphasize that all AI decisions remain subject to physician oversight during the pilot and that the program must be completed before meaningful conclusions about long-term safety can be drawn.
No serious incidents
“To date, no serious safety incidents have been reported to the Office by either Doctronic or the public […]. The Office has received anecdotal feedback describing potential benefits, including multilingual support, 24/7 availability, immediate feedback on requests, and more thorough collection of medical history where applicable. Some pharmacists have noted operational convenience in cases where patients require prescription reauthorization,” informed the Department of Commerce in Utah.
Beyond its prescription-renewal system, Doctronic offers an AI health platform that analyses patients’ health information and provides assessments, treatment recommendations and medication guidance. Its AI draws on peer-reviewed medical research and clinical guidelines, using a proprietary medical knowledge graph and retrieval-augmented generation (RAG) to access relevant clinical evidence. Licensed physicians are available when a prescription, further evaluation, or human care is needed.
Doctronic says its AI platform is free, while consultations with licensed physicians cost US$39 out of pocket or are covered by insurance, depending on the patient’s plan.
