Manufacturing is the foundation of a nation and the basis for a strong country，as it is closely tied to the economic lifeline of a state. The pharmaceutical manufacturing industry is intimately related to life and health. The Beijing-Tianjin-Hebei （Jing-Jin-Ji） region has established a biopharmaceutical cluster，where the pharmaceutical manufacturing industry plays a crucial role. This study assesses the competitiveness of the pharmaceutical manufacturing sectors in the Jing-Jin-Ji region，the Yangtze River Delta，and the Pearl River Delta，as well as related provinces and cities from 2012 to 2022，focusing on three aspects：industry scale，efficiency，and effectiveness. The findings indicate that the revenue，asset scale，employment numbers，and total profit of the pharmaceutical manufacturing industry in the Jing-Jin-Ji region exhibit an overall upward trend. Notably，in 2021，due to the impact of public health events，there was an increased demand for pharmaceutical products，leading to rapid growth in the industry scale of pharmaceutical manufacturing in the Jing-Jin-Ji region，which played a vital role in ensuring the supply of medicinal products to society. In terms of industry efficiency，the asset productivity in the Jing-Jin-Ji region shows a downward trend，while labor productivity and total factor productivity exhibit an upward trend. Regarding industry effectiveness，only the per capita profit margin in the Jing-Jin-Ji region shows an upward trend，whereas both the capital profit margin and comprehensive profit margin have declined. Among the three major regions，the Jing-Jin-Ji region still has room for improvement in industry scale，efficiency，and effectiveness. It is recommended to strengthen top-level design，enhance technological innovation，reinforce talent support，and deepen the collaboration within the Jing-Jin-Ji region to promote the high-quality development of the pharmaceutical manufacturing industry.