* Sees 2021 sales in local currencies up 5-9%

* Sees 2021 op profit in local currencies up 4-8%

* Q4 results in line with expectations

COPENHAGEN, Feb 3 (Reuters) - Diabetes drugmaker Novo Nordisk forecast a rise in underlying sales and profit for 2021 on Wednesday and said it expected more Americans to get access to its drugs under the new Biden administration.

Novo Nordisk, the world's biggest manufacturer of diabetes drugs, posted fourth-quarter results in line with expectations, as more patients began treatment with its drugs even as some existing ones used stocks built up at the start of the pandemic.

Rival Eli Lilly said last week it had seen strong demand for diabetes drugs in the fourth quarter.

However, Novo said higher U.S. unemployment had hit sales as some patients were pushed out of corporate insurance plans, leaving them to rely on other insurance coverage such as the government-run Medicaid or pay for diabetes drugs themselves.

"It's clear that under the new Biden administration, healthcare is high on the agenda," Chief Executive Lars Fruergaard said at a conference call.

U.S. President Joe Biden has given more Americans access to government healthcare insurance programmes.

"What we saw with Obamacare was that it led to bigger volumes, but also a higher cost to the industry to fund those volumes," Fruergaard said, referring to the health insurance programme introduced by former U.S. president Barack Obama.

Novo said it expected 2021 sales in local currencies to rise by 5%-9% and operating profit by 4%-8%. But currency headwinds are expected to reduce sales growth by 4 percentage points when reported in Danish crowns, while operating profit growth will be 6 percentage points lower, the company forecast.

Operating profit for October-December fell 6% from a year earlier to 11.2 billion Danish crowns ($1.81 billion), in line with analysts' forecast.

Novo's sales stood at 32.1 billion crowns in the quarter, compared with analysts' average estimate of 31.8 billion.

($1 = 6.1773 Danish crowns) (Reporting by Jacob Gronholt-Pedersen. Editing by Kim Coghill and Mark Potter)