Background: A competitive advantage in health care institutions can be cultivated by marketing activities and value creation for patients with chronic diseases in primary health care. Type 2 diabetes mellitus (T2DM) is a major challenge in primary health care, as managing risk factors and managing patient knowledge can help to prevent a number of major of complications. This study reveals the expectations and attitudes of patients with T2DM regarding marketing mix elements in the management of their condition. Aim of the study: To explore the perspectives of patients with T2DM on marketing mix elements in the primary health care institutions of Lithuania. Materials and methods: The design of the national study was based on a survey of patients with T2DM that was conducted after consultation with a family physician in primary health care institutions in Lithuania. The survey was conducted from October 2017 to January 2018, and involved 510 patients with T2DM. Data analysis included factor analysis and linear logistic regression. A hypothetical model was built, defining the relationships between marketing mix elements and both perceived value (emotional, functional, and social) and satisfaction with primary health care services. Results: The marketing mix element of 'Service' is statistically significantly dependent on the gender of the respondents, and is expressed more frequently by women (rcr = 0.118, P = 0.007). The occupation of respondents with T2DM (rcr = 0.151, P = 0.009) and affiliation to primary health care institution (rcr = 0.091, P = 0.040) statistically positively affect the marketing mix element of 'Price'. The marketing mix elements of 'Promotion' and 'People' do not statistically significantly depend on the sociodemographic characteristics of the respondents. Only a weak correlation between the sociodemographic characteristics of the respondents and the marketing element of 'Place' was found. The 'Process' element is statistically significantly more relevant to patients with an average monthly income of €350 (rcr = 0.104, P = 0.019). The element of 'Physical evidence' is more statistically significantly related to respondents with an average monthly income of €350 (rcr = 0.092, P = 0.038). Conclusions: Marketing mix analysis provides information about patients' expectations of primary health care services and identifies areas of improvement for the health services provided by primary health care institutions. The competitiveness of primary health care services is strengthened by enhancing value for patients, by using elements of the health care marketing, and by increasing patient satisfaction.