OBJECTIVE: To understand the impact of free medication on the follow-up effect of patients with type 2 diabetes in Tianchang City, so as to provide reference for the optimization of the free chronic disease drug distribution policy in Tianchang City. METHODS: Based on the management data of type 2 diabetes patients in Tianchang City in 2023, 539 permanent residents aged 35 and above who were newly included in the management of type 2 diabetes patients in Tianchang City in the first quarter of 2023 were selected as the research subjects, and the effect of free medication on the follow-up effect of type 2 diabetes patients was studied using propensity score matching. CONCLUSIONS: The mean treatment effect (ATT) of free medication on blood glucose control, medication compliance, psychological adjustment and medical compliance in patients with type 2 diabetes mellitus in Tianchang City were 0.068, -0.369, -0.274 and -0.349, respectively, which had a positive effect and significant effect. Overall, actively encouraging free medication will help promote the health management of patients with type 2 diabetes in Tianchang City. CONCLUSION：To a certain extent, free medication can play a positive role in improving the medication compliance of hypertensive patients in Tianchang City, and improving the psychological adjustment and medical compliance behavior of patients with type 2 diabetes mellitus in Tianchang City.