US bill proposes allowing AI to prescribe medications

A newly proposed bill in the United States Congress could pave the way for artificial intelligence (AI) to legally prescribe medications. If passed, the legislation would mark a significant shift in the integration of AI and machine learning technologies into medical practice, potentially expanding access to prescriptions for individuals who face challenges in securing timely healthcare appointments.

The bill, introduced by Representative David Schweikert (R-Ariz.), aims to amend the Federal Food, Drug, and Cosmetic Act, clarifying that AI systems could qualify as practitioners eligible to prescribe medications. However, these AI-driven prescribing systems would need to be both authorised by the respective state and approved by the U.S. Food and Drug Administration (FDA).

The proposed legislation was introduced in the U.S. House of Representatives in January and subsequently referred to the House Committee on Energy and Commerce for further discussion.

A Premature Move? Experts Express Caution

Despite the bill’s potential to address gaps in care, many medical experts believe that AI is not yet sophisticated enough to take on the role of a prescriber. Dr Adam Rodman, MD, MPH, a hospitalist and director of AI programmes at Beth Israel Deaconess Medical Center, as well as an assistant professor at Harvard Medical School, expressed scepticism about the current feasibility of AI-driven prescribing.

“The technology is not nearly where it needs to be for this kind of prescribing,” Rodman told MedPage Today. However, he acknowledged the rapid pace of advancements in AI. “Things are accelerating so quickly,” he said, adding, “I don’t doubt that we will be having this conversation” in the near future.

Rodman believes the bill reflects a broader enthusiasm for AI technology and its potential to bridge existing healthcare gaps. With many individuals facing difficulties in securing medical appointments, AI could, in theory, provide a solution.

However, significant concerns remain. Dr Stephan Fihn, MD, MPH, an internal medicine physician and professor at the University of Washington, warned that such a system would require an extensive regulatory framework to ensure safety and efficacy.

“There would have to be huge sets of regulations that govern this,” Fihn told MedPage Today. He pointed out that the bill does not currently specify which types of medications AI would be permitted to prescribe, in what settings, or whether human physician oversight would be required.

The Expanding Role of AI in Medicine

AI is already being applied in multiple areas of medicine, with its applications growing at a rapid pace. However, Fihn, who also serves as executive deputy editor of JAMA Network Open, believes that allowing AI to prescribe medications is a premature step.

“The application of AI and machine learning technologies, as described in the bill, seems premature,” he stated. “It appears to enable the actual prescribing of drugs, some of which are very low risk, and some of which are very high risk.”

He compared the issue to the introduction of autonomous vehicles, which have faced high regulatory scrutiny. AI-driven prescribing, he predicted, would likely be subject to similarly stringent standards. “My suspicion is that there will be a very high bar for approving these, at least initially,” he said.

Despite his reservations, Fihn ultimately believes AI prescribing could be a reality in the future. “I think it will come to be,” he said. “And to be honest, properly developed, properly tested, properly managed, and highly regulated, it could be a good thing. But this has to be proven and shown.”

The Legislative Landscape and AI’s Role in Healthcare

Representative Schweikert has yet to provide further comment on the bill, but he has previously expressed strong support for AI’s role in improving healthcare efficiency. In an interview last year with Nextgov/FCW, he argued that AI could be instrumental in reducing government costs.

“Technology has to be part of the way we bend the borrowing and debt curve,” Schweikert stated, highlighting how the broader adoption of AI could “make government better, faster, cheaper” in meeting Americans’ needs.

He also pointed to AI’s growing role in improving diagnostics and optimising both administrative and clinical operations in healthcare. “It’s here, we now just have to build the infrastructure around it,” he said, describing the emergence of a “new medical landscape.” However, he also acknowledged that “technology is starting to move much faster than our regulatory rules.”

This is not Schweikert’s first attempt at pushing for AI-driven prescribing. In January 2023, he introduced a similar bill with the same objective, but it ultimately did not advance out of committee.

A Future of AI-Driven Healthcare?

AI’s role in healthcare continues to evolve, and discussions around its potential are ongoing. In February 2024, a panel hosted by the Kaiser Family Foundation explored AI’s role in simplifying prior authorisation processes. Experts on the panel stressed the importance of “complete transparency” in AI’s use within the healthcare system.

The American College of Physicians has also weighed in on the matter. In a policy position paper published in June 2024, the organisation stated that AI should “complement, not supplant” the decision-making of physicians and other clinicians. This stance underscores the broader concern that AI should serve as an assistive tool rather than replacing human expertise.

As Schweikert’s bill moves through the legislative process, it remains unclear how much support it will garner or whether it will ultimately become law. The concept of AI prescribing medication may have seemed like science fiction only a few years ago, but the landscape is shifting.

“This isn’t sci-fi,” Rodman noted. “It’s just we aren’t there yet.”