Nolla Health announced it has won state approval to become the first U.S. startup whose artificial intelligence can write initial prescriptions, starting with topical acne treatments under a 12-month pilot in Utah. The distinction matters: existing telemedicine platforms like Curology, Hims, and Musely require a licensed clinician to review every case before prescribing.
Utah's Office of Artificial Intelligence Policy carved a narrow exception for Nolla's AI to issue a first prescription directly, then hand physicians a retrospective audit trail. Three other approved Utah pilots cover prescription renewals only. Those companies include Doctronic, Legion Health, and August AI.
The workflow is straightforward, if tightly controlled. A patient in Utah verifies identity with a government photo ID, completes a 10- to 15-minute intake, and submits a five-angle facial scan through the Nolla Derm app. If the AI selects a treatment from its short formulary (topical retinoids, benzoyl peroxide combinations, azelaic acid), the prescription transmits to a pharmacy within minutes under an overseeing physician's National Provider Identifier.
Cases that fall outside the narrow list escalate to a doctor. Severe acne, pregnancy, immunosuppression—all trigger human review.
"The AI can't improvise," said Dr. Zaid Fadul, chief medical advisor at Nolla Health, in the company's press release. "It can only choose from a short list of physician-approved topical treatments. The moment a patient falls outside those limits, it stops and hands them to a doctor."
The pilot costs $4.99 a month for Utah residents 18 and older. Medications are priced separately; a compounded option covering both morning and evening drugs runs $49.99.
Utah regulators required a phased safety protocol that unfolds in three stages. For the first 100 patients, two Utah-licensed physicians must review and approve every prescription before it goes out, a minimum of four weeks. Stage two covers the next 400 patients: the AI submits directly, and physicians review 100% of cases retrospectively every week for at least eight weeks. The final stage shifts to monthly sampling of at least 10% of prescriptions, plus full review of any adverse events or escalations.
Advancement between stages requires written approval from the Office of AI Policy and a safety threshold of at least 95% agreement between the AI and reviewing physicians, with zero serious adverse events. The company said licensed clinicians agree with its treatment recommendations in over 96% of real-world cases, though it did not specify the sample size or timeframe for that figure.
CEO Luis Wenus, a former early employee who led go-to-market at Worldcoin, co-founded the New York startup. A General Catalyst job listing referenced a $6.5 million total raised to date, though the company has not issued a separate funding announcement. LinkedIn showed 11 to 50 employees as of late September.
Nolla said the app has logged 175,000 downloads across 44 states.
Utah signed the agreement September 22; the pilot runs through October 5, 2027. The state can terminate at any time. Nolla must report adverse events within 24 hours and submit monthly metrics to regulators: AI–physician agreement rates, escalation counts, and any serious safety signals.
The pilot bars oral medications, isotretinoin, and any systemic therapies. Pharmacists are notified that the prescription originated from AI and given a physician contact. The company cannot sell or transfer patient data under the terms. Liability insurance is required.
The regulatory environment remains contentious. Utah's Medical Licensing Board objected to an earlier refill-only pilot by Doctronic in April, urging suspension. The Office of AI Policy declined, adding guardrails and publishing a public response. Director Zach Boyd said in Nolla's press release that "the Nolla Health pilot program represents a significant step forward in leveraging AI to improve healthcare access for Utahns, while maintaining rigorous oversight and safety."
Whether the broader medical community shares that view is unclear. The company will track progress through daily skin scans and review treatment plans after every 28 scans, roughly one to two months. Nolla has not disclosed how many Utah users have enrolled or whether the pilot has advanced past stage one. State regulators will publish quarterly reports.
"AI will matter most in healthcare when it helps people get care they otherwise would not receive," Wenus said. "With Nolla Derm, we are showing how AI can responsibly expand that access and help someone get personalized treatment in minutes instead of long waits or going without care altogether."
