Good morning. This is Mona, the Investor Relations from Waterdrop. I'm happy to welcome everybody to the Waterdrop 4th quarter and full year 2022 earnings call. Please note that you are in listen-only mode, as today's event is being recorded. Please also note that the discussion today will contain forward-looking statements made under the safe harbor provisions of the U.S. Private Securities Litigation Reform Act of 1995. Forward-looking statements are subject to risks and uncertainties that may cause actual results to differ materially from our current expectations. Potential risks and uncertainties include, but are not limited to, those outlined in our public filings with SEC. The company does not undertake any obligation to update any forward-looking statements, except as required under applicable law. This call includes discussion of certain non-GAAP measures. Please refer to our earnings release for a reconciliation between non-GAAP and GAAP.
Joining us today on the earnings call are Mr. Shen Peng, our Founder, Chairman, and CEO. Mr. Yang Guang, Co-founder, Director, Finance VP, and GM of International Business. Mr. Ran Wei, Director, GM of the Insurance Technology Business. Mr. Zhu Zet ao, GM of Crowdfunding and Pharma Tech Business. Mr. Chen Richard , Board Secretary. We'll be happy to take your questions in the question line at the end of the conference call.
Hello, everyone. Thank you for joining our fourth quarter 2022 earnings conference call. Looking back on 2022, the downside risk of global economy and the resurgence of pandemic put tons of pressure on the domestic economy. However, as China made efforts to deepen the stable growth and loosen the provision measures, the domestic economy and the consumer confidence are gradually showing signs of recovery.
Under the guidance of policies, the insurance industry has enhanced the trait of high quality development and continues to calculate the efficient operation. In the long term, the insurance industry still has great potential, since the demand for insurance continues to grow. Meanwhile, the pharmaceutical industry is entering a new age benefited from the acceleration of the clinical trial through business model innovations. Facing the headwinds, we insisted on pursuing sustainable development by creating value for users, which demonstrates business resilience. In the fourth quarter, our revenue continued the profit trend of the last three quarters, increased by 12.5% year-over-year. Our GAAP net profit reached RMB 126.2 million in the fourth quarter and RMB 608 million for the whole year. We have delivered our commitment on overall profitability for our established business in the year of 2022.
As of the end of December, our cash and cash equivalents and short-term investments amounted to RMB 3.7 billion, increasing 3.2% quarter-over-quarter. Even taking into account our repurchase program, we were able to generate a positive cash inflow of RMB 1.15 million in the fourth quarter. Our ample cash reserves and ability to generate positive cash flow put us in a strong position to withstand the ever-changing environment and make future-oriented arrangements. Our businesses are showing positive traits. Specifically, under the pressure of industry adjustments, our Waterdrop insurance marketplace continues to contribute net profit and cash flow by enriching our products and improving service capabilities. As a pathfinder and leader of med tech crowdfunding industry, Waterdrop medical crowdfunding platform has expanded its market share by transparent operations.
It has taken only, just one year for E-Find patient platform to transform from a nascent business to an industry leader. In the fourth quarter, the revenue generated from E-Find exceeded RMB 22 million, increasing 40 times year-over-year. The annual revenue reached to nearly RMB 50 million. E-Find has become our group driver. Leveraging the patient recruitment capability, we are also actively exploring the opportunities in CRO and CSO. As an internet company, we will continue to invest in R&D to build a long-term moat. In the fourth quarter, we further upgraded the intelligent dialogue platform to empower our businesses. We also achieved good results in AI-plus-human projects, and we continue to build the underlying technical capabilities to further reduce expenses and increase efficiency. In the fourth quarter, we actively carried out our share repurchase program.
We repurchased approximately 2.7 million ADSs in total. We are continuing to execute presently for the one-year extension program. At the end of 2022, we had repurchased almost 8.4 million ADSs from the open market for a total consideration of $12.4 million. This demonstrates our strong confidence in our corporate value. Meanwhile, we plan to reserve this share for share incentive plan, which will align the interests of our employees with our company. Above is a review of our business in the fourth quarter. We have confidence in both the industry and our results. Going forward, we will continue to pursue high quality growth on the promise of profitability.
To achieve our goals, our strategies include: First, for the insurance business, we will adhere to the digital transformation to expand user coverage and improve sales capabilities to achieve sustainable profit quality. Second, we will increase the investment in pharmaceutical area to be with long-term growth driver. Third, leveraging abundant cash reserves, we will seek M&A and other opportunities around the insurance and pharmaceutical sectors and continue to invest in R&D to empower the core industry. In the end, I'd like to emphasize that we will continue to cultivate our business and insist it on user-centric developments to further enhance our industry-leading position. With economic recovery, a supportive policy and abundant cash reserves, our technical insurance business and fast growth in pharmaceutical business continue to grow in their own tracks, allowing us to face the market shifts deliberately.
I'll pass to Ran Wei to discuss the performance of the Waterdrop insurance business in Q4.
Thank you, Shen Peng. Hello, everyone. Let me give you an update on our insurance business. With the complex external environment, with a surging epidemic across the country and soft consumer demand, plus the profound adjustments of life and health insurance industry, the growth rate of book year premiums has not improved significantly. Against the backdrop, our first year premiums amounted to RMB 1.6 billion. The insurance-related revenues reached RMB 611 million. However, since they insisted on high-quality developments, our insurance business remained resilient and continued to contribute all the profits. We also firmly established the bottom line by driving better ROI and using budgets more efficiently.
In the fourth quarter, we leveraged the management of existing users by digging into our business, constantly improve user experience and their value perception. The number of policies per capita increased by 18% quarter-over-quarter, and the repeating purchase rate and renewal rate remained at high levels of over 60% and 90%. The ATL of existing users increased 7% quarter-over-quarter since they continued to improve operational efficiency. We proactively explored customer acquisition channels on various social media platforms. The overall number of new customers increased by 39%. In WeChat video accounts, the new customers increased by 166% quarter-over-quarter. It has already achieved profitability, laying a solid foundation for further expansion. In our built-in live stream, our operators based on the current events and identified users with high willing to consume.
Our sales team will follow up timely to provide financial consulting service for them. Leveraging our direct to consumer experience and the ability to deliver high impact content, the number of consumers in the short video platform increased by 371%. In the other hand, we collaborated with industry players to obtain sales leads. Benefiting from our sales conversion capabilities, the ATL of a single lead increased by 60% quarter-over-quarter. Our online brokerage makes great sale in customer acquisition and conversion. By locating target groups, delivering compelling creative content, and reinforcing user acquisition capabilities, our natural traffic increased by 36% quarter-over-quarter. Meanwhile, the average lead cost decreased by 17%, and we further improved the account coverage and the content pipeline. The number of accounts increased by 100% quarter-over-quarter.
By uploading the user conversion model, we formed a working mechanism for the insurance planner, and thereby the ATL increased by 140% quarter-over-quarter. In this quarter, the offline brokerage showed a substantial growth with a year-on-year increase of 229%. We have expanded our business to 11 cities across China, including Beijing and Shanghai. Meanwhile, the synergy effects with online brokerage has boosted the transformation of O2OE. In terms of distribution channels, we made progress in optimizing our distribution network with 13 new partners on board in this quarter. We focused on the exploration of the insurance planner model in the fourth quarter. They provided users with in-depth one-to-one service through enterprise WeChat.
We take a medical insurance product as the trigger to gradually educate users and improve their insurance awareness. Then expand to annuity insurance and life insurance products. The ATL in December increased by 60% compared with October of our year mix. Regarding our product and innovation in the fourth quarter, we deeply explore user needs and strongly develop many new products with insurance. For instance, we co-designed with a world health insurance to launch a customized product against leukemia recurrence for the patients to meet their protection needs. Another example is that we launched a post-effective accident insurance. The total premium has exceeded RMB 10 million. It has become a benchmark product in the market. We have further upgraded million medical insurance products and made explorations in the early screening of cancers and cardiovascular disease.
We concluded partnerships with two new insurance in this quarter and expanded the breadth and depth of cooperation with certain insurance such as Taikang Life Insurance and Ping An United. As a tech technology company, we sustained our investments in AI-driven innovation, laying a solid ground for our medium and long-term growth. For example, we released a robot configuration platform under a new architecture to enable our robots to realize a faster self-training progress in different scenarios, optimize our intelligent sales lead matching system, and included more kinds of sales leads and workplaces. We used AI to help sales team identify potential customers in WeChat, and thereby the premium boosted by hundreds of thousands. We also strengthened our risk control capabilities, applying AI to improve both operational efficiency and user experience, which significantly reduced the complete rate. We empowered industry with our technology.
In Q4, we successfully integrated and exported the selected products of our industry-leading CRM system. At the end of December, we exported our thin screen interactive technology to the industry partners, which simplified the sales process and optimized their ability to communicate with customers. This concludes my briefing on our insurance products. Let me hand over to Zhu Zetao for an update on our medical crowdfunding and patient recruitment business.
As of the end of Q4, a cumulative total of 426 million donors helped exceeding 2.7 million patients raised around RMB 57 billion on our platform. In this quarter, the operational transparency committee made further improvements. For instance, we released a monthly bill includes the overview and breakdown of the money raised in our platform, which marks that not only can we achieve the transparency of a single campaign, but also the transparency of the whole fundraising platform. The billing system includes the total number of campaigns, details of raised funded and withdrew. It also shows the cash flow from the donors to the fundraisers. In addition, a detailed list of monthly closed cases and a useful search tool are provided for the public oversight and monitoring. Besides, we can also fully disclosure the case review procedure and its corresponding results through Weibo.
To be specific, when a campaign was initiated, the strong cases will be identified and intercepted under certain scenarios, including concealing the financial conditions, counterfeiting personal information, using funds to buy a house or car, used to be listed on our blacklist or other behaviors that do not comply with our fundraising rules. On the other hand, during the fundraising process, any campaigns related to the need of appropriation of funds, the bank account and medical bills will also be identified and intercepted. We will also publicize the rationale and decisions to deal with those controversial cases on the various scenarios, further enhancing the transparency under the public overall. In the fourth quarter, the development of clinical trials was impacted by the pandemic in many places around the country, and therefore, the progress of many clinical trials were hindered.
Leveraging the advantage of our wide coverage across the country and capabilities in quickly and accurately recruiting patients. The E-Find patient platform enrolled nearly 700 patients to over 200 clinical trials, significantly accelerating the trial progress of our partners. Thanks to our industry reputation and excellent project performance, the number of clinical trial programs continues to grow, with nearly 18 new programs launched in this quarter. At the end of Q4, we already collaborated with over 100 pharmaceutical companies. In the meantime, we also kept good relations with our regular customers and continuously expand this group of cooperation.
For example, Yiyi collaborated with Celgene for the first time in early 2022 to participate in the patient recruitment for a certain tumor clinical trial, which require patients to have qualifying factors such as genetic mutations. Leveraging our normal patient pool and digital capabilities, we enrolled many patients in a very short time, which effectively promoting the trial programs that have been highly recognized. As a result of this, Beijing and Leadfine continue to deepen cooperation with five new product projects launched in this quarter. At present, we are also promoting cooperation with a number of world-leading pharmaceutical companies, and is expected to complete the supplier review in 2023 and formally launch cooperation. In addition, we also upgraded the ecosystem composed by the pharmaceutical companies, doctors, and patients, and explored new directions of healthcare visualization, dislocation operations, and other potential business directions.
We invested in R&D in the medical field and the role benefited from the ongoing upgrade. Our medical algorithm platform covers almost 100% of diseases and can ultimately extract it and identify criteria, medical intentions, and medicine information, which improves the operational efficiency. In addition, the algorithm can be used to increase the one-time upload success rate of Dangdang claims, which demonstrates the synergy effects between our pharmaceutical business and insurance business. I'll now hand over to Yang Guang to discuss our full quarter financial performance.
Thank you, Zetao. Hello, everyone. I will now walk you through our financial highlights for this full quarter and full year of 2022. Before I go into details on the financial performance, please be reminded that all numbers quoted here will be in RMB.
Please refer to our earnings release for detailed information on our comparative financial performance on both the year-over-year and quarter-over-quarter basis respectively. Despite of the challenging external environment, we invested on the high-quality development. Our net operating revenue increased by 12.5% year-over-year to RMB 639.5 million, which primarily due to the increase of insurance-related income, consulting service fees, and digital clinical trial so-solution income. The operational costs and expenses decreased by 10.5% year-over-year and 5.2% quarter-over-quarter, amounting to RMB 606.6 million, driven by the financial discipline taken since the third quarter of 2021. To break it down, operating costs were RMB 278.6 million, up by roughly 41% year-over-year.
Mainly due to the increase in professional and outsource customer service base of RMB 51.2 million, and the recording of consulting-related services of roughly RMB 67 million from sales and marketing expenses to operating costs. They started to generating consulting service fees since April 2022. Partially offset by around RMB 41 million decrease in personnel costs for our consultants and insurance agent team. On a quarter-over-quarter basis, operating costs decreased by 18.4% as a result of the professional and outsource customer service base decreased by around RMB 25 million. Sales and marketing expenses decreased by 42.8% year-over-year to RMB 137.8 million, which was primarily due to a RMB 36 million decrease in marketing expenses to third-party traffic channels, and exactly RMB 18 million decreases in outsource sales and marketing services to third parties.
On a quarter-over-quarter basis, our sales and marketing expenses almost remained unchanged. Our G&A expenses decreased by 20.7% year-over-year to RMB 118.6 million, due to the combined impact of a decrease of RMB 39 million in impairment loss, and partially offset by an increase around RMB 50 million allowance for doubtful accounts, and a RMB 7.7 million decrease in personnel costs. On a quarter-over-quarter basis, it increased by 44.5%, primarily due to the increase in allowance for doubtful accounts, professional service fees, as well as the share-based compensation expenses. In this quarter, the R&D expenses decreased by 21.2% year-over-year and 8.5% quarter-over-quarter to RMB 71.7 million. Which was primarily due to the decrease in R&D personnel costs.
In Q4, we reported a non-GAAP profit of RMB 159.7 million and a GAAP profit of RMB 126.2 million, compared with an adjustment net profit of RMB 5.9 million for this same period of 2021. The profits we have generated over the past five quarters illustrate the determination and achievement of cost discipline and profit enhancement. As of December 31, 2022, our cash and cash equivalents and short-term investments increased 3.2% quarter-over-quarter to RMB 3.7 billion, as we continue to generate positive operating cash flow. In conclusion, we have committed our financial guidance of achieving a non-GAAP profit in the year of 2022. Going forward, we will continue our efforts in cultivating our business, enhancing our revenue policy, and adapting cost reduction.
Our confidence is underscored by the resilient business, ongoing momentum, and most importantly, our team's unwavering commitment to deliver best-in-class service to our customers. Ladies and gentlemen, with that, we will conclude today's conference call. We do thank you for joining.
The conference has now concluded. We thank you for attending.