However, research on optimal pricing strategies and social welfare optimization for diabetic pharmaceutical supply chains under different power structures and supply disruption risks remains insufficient. It explores the impact of supply disruption risks on pricing strategies for the two diabetic drugs under three power structures: Supplier–Stackelberg (SS), Drugstore–Stackelberg (DRS), and Centralized Setting (CS). It consistently yields the highest total supply chain profit compared to decentralized structures. Drugstore–Stackelberg (DRS)dominates CS in terms of social welfare under low to moderate procurement costs, especially for generic diabetic drugs. Supply disruption risk (dr) has a negative impact on the profit of most supply chain members (except the third backup supplier) and reduces social welfare and consumer surplus.