Objective: The paper analyzes the prominent problems in the order of pharmaceutical procurement, systematically evaluates the implementation effectiveness of the credit evaluation system of pharmaceutical pricing, bidding and procurement, and proposes optimization strategies. Methods: Based on policy text analysis, official statistical data, and typical cases, combined with the practical experience from the system’s establishment in 2020 to its revision and improvement in 2025, a systematic analysis was conducted using a problem-countermeasure-effectiveness logical framework. Results: The pharmaceutical procurement market faces transactional chaos, such as kickback sales, false invoicing, and bid-rigging. Price mechanism failures lead to inflated declared prices, vicious competition cycles, and low default costs. Traditional regulatory methods lag behind, and cross-departmental information sharing is inadequate. The credit evaluation system has effectively curbed violations through five mechanisms: standardizing the entire transaction process, strengthening data collaboration, tightening evaluation criteria, balancing punishment with guidance, and protecting enterprises’ legitimate rights and interests. As of January 2026, a total of 1236 enterprises have been assessed as enterprises with credit violations nationwide, more than 10 typical cases have been publicly notified, and most enterprises with credit violations have completed credit restoration by reducing prices or returning unreasonable profits. Conclusion: The credit evaluation system of pharmaceutical pricing, bidding and procurement is an effective policy tool for standardizing the procurement order and enhancing regulatory effectiveness. Future efforts should further refine evaluation criteria, deepen cross-departmental collaboration, and promote the application of credit evaluation results in more scenarios.