* Novo wants insurance-covered, self-pay volumes to be equal

* Direct-to-consumer sales are 30% of Novo's injectable

volume

* Broader reimbursement needs predictable volume to work

By Chris Prentice

NEW YORK, June 25 (Reuters) - Denmark's Novo Nordisk

, the maker of weight-loss drug Wegovy, hopes

insurance will cover more U.S. users of the medication and

balance direct-to-consumer sales that have driven the

fast-growing market, the company's top U.S. executive said.

Demand for obesity and weight-loss medications from Novo,

which also sells the drug as Ozempic for diabetes, and U.S.

rival Eli Lilly ( LLY ), maker of Zepbound, Mounjaro and

Foundayo, has been booming, even as employers and health plans

push back against covering their cost.

For Novo, direct consumer purchases account for 30% of its

injectable GLP-1 weight-loss drug sales measured by volume and

about 90% of its Wegovy pill, which launched in the U.S. in

January, U.S. Executive Vice President Jamey Millar said in an

interview on Wednesday.

Millar hopes that sales mix will evolve toward an equal

split between the insurance-covered and self-pay segments for

both forms of the medication.

"There are benefits to the traditional model," he told

Reuters. "That's why I'd like to see more balance, but we've got

to solve the cost trend concern for that to be the case."

Wegovy has a U.S. pharmacy list price of about $1,350 a

month, but Novo has said it will reduce the cost to $675 in

2027. Self-pay consumers can buy Wegovy for $149 a month under

manufacturer discount programs.

Many people have proved willing to shell out their own cash

for the medications, a rarity for prescription drugs which have

traditionally been paid for by employers, insurers and the

government.

Millar said patient demand for the drug to treat a severe

form of fatty liver disease - which became eligible for coverage

in 2025 - is a small but growing part of the business.

BALANCING PRICING AND VOLUME

Not all insurance companies cover GLP-1s, and some are planning

to drop coverage as more people take the medications. Health

insurer Cigna has notified its employees it plans to end

coverage in July.

The pharmaceutical companies have begun to offer pricing

discounts to address cost concerns.

Novo is seeking to expand coverage of GLP-1s in the U.S.

while trying to reassure payers that any increase in sales

volume can be kept predictable, Millar said.

"If all of a sudden, the flood gates opened, the cost trend

would be impermissible" for payers, Millar said. "So we're

engaged in that conversation. That's what has to be solved."

GOVERNMENT PILOT PROGRAM

Novo expects a bump in demand when the U.S. government rolls out

a pilot program in July covering GLP-1s for weight loss for

people enrolled in Medicare, which covers Americans age 65 or

older and people with disabilities.

Medicare already covers the drugs for conditions including

cardiovascular and severe fatty liver diseases, but the pilot

will be the first time it covers GLP-1s for weight loss alone.

The new program, which runs through 2027, will give older

adults access to the drugs for $50 a month.

Millions of people are expected to take advantage of the

program.

Novo's Millar declined to provide sales volume estimates for

the program.