By Ludwig Burger and Maggie Fick

FRANKFURT Novo Nordisk has launched blockbuster weight-loss drug Wegovy in Germany, its first big European market, hoping Germans will pay hundreds of euros out of pocket for a drug that public health insurance plans are so far barred from covering.

The drug, shown to help patients reduce body weight by around 15% when used along with exercise and lifestyle changes, is already available in the United States, but in Europe is so far on sale only in small markets Norway and Denmark.

A spokesperson for Novo confirmed on Saturday that German patients had received their first prescriptions, in line with previously announced plans to launch the drug there at the end of July.

The Danish drugmaker's share price has more than doubled in the two years since the drug debuted, turning Novo into Europe's second-most-valuable listed company after LVMH.

Doctors and patients in Germany have told Reuters they anticipate high demand for the weekly injections, with many patients prepared to take on the cost, starting at 170 euros ($190) a month and rising to more than 300 euros as treatment requires the dosage to increase.

Public health insurance plans, which cover about 90% of Germans, will not foot the bill, under a decades old law that bars them from covering weight-loss drugs.

For the 10% of Germans with private health insurance, coverage will vary. Among major providers, Allianz says it will pay if a physician diagnoses a medical need, while Debeka said its plans exclude weight-loss treatments.

Patient advocates and physicians have welcomed the arrival of Wegovy in Germany, where 18.5% of adults are obese, above the European Union average of 16%.

The Robert Koch Institute, Germany's state public health agency, says diseases linked to excess body weight pose a considerable burden on health and social security systems.

Novo is ramping up production to meet soaring demand in the United States, where the drug sells for as much as $1,350 a month. It says it will closely monitor prescriptions in Germany to ensure access for people with obesity, but it cannot not rule out supply delays.

In Germany, Wegovy will be administered with the same injection pen used in Norway and Denmark, different from the one used in the United States, to avoid hitting supplies there.

Wegovy's introduction in Germany will stir debate in a nation where the health care system has often treated obesity as a lifestyle choice rather than a chronic disease.

Doctors say many Germans seeking to lose weight have already used Ozempic, a diabetes drug also made by Novo that is a lower dose version of the same ingredient as Wegovy.

Physicians have worried that supplies would be strained by non-obese people seeking "vanity" prescriptions - a concern reflected in a Novo statement in mid-July saying physicians should "prescribe responsibly".

($1 = 0.8984 euros)

(Reporting by Ludwig Burger in Frankfurt and Maggie Fick in London)