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CONSOLIDATED STATEMENTS OF STOCKHOLDERS' EQUITY - USD ($) shares in Thousands, $ in Thousands | Common Stock [Member] | Common Stock [Member] Novartis [Member] | Common Stock [Member] Biogen Inc. [Member] | Additional Paid In Capital [Member] | Additional Paid In Capital [Member] Novartis [Member] | Additional Paid In Capital [Member] Biogen Inc. [Member] | Accumulated Other Comprehensive Loss [Member] | Accumulated Other Comprehensive Loss [Member] Novartis [Member] | Accumulated Other Comprehensive Loss [Member] Biogen Inc. [Member] | Accumulated Deficit [Member] | Accumulated Deficit [Member] Novartis [Member] | Accumulated Deficit [Member] Biogen Inc. [Member] | Total Ionis Stockholders' Equity [Member] | Total Ionis Stockholders' Equity [Member] Novartis [Member] | Total Ionis Stockholders' Equity [Member] Biogen Inc. [Member] | Noncontrolling Interest in Akcea Therapeutics, Inc. [Member] | Noncontrolling Interest in Akcea Therapeutics, Inc. [Member] Novartis [Member] | Noncontrolling Interest in Akcea Therapeutics, Inc. [Member] Biogen Inc. [Member] | Total | Novartis [Member] | Biogen Inc. [Member]
--- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | ---
Increase (Decrease) in Stockholders' Equity [Roll Forward] |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Cumulative adjustment related to adopting Topic 606 revenue recognition guidance | Topic 606 [Member] | $ 0 |  |  | $ 0 |  |  | $ 0 |  |  | $ (86,108) |  |  | $ (86,108) |  |  | $ 0 |  |  | $ (86,108) |  |
Balance at Dec. 31, 2015 | $ 120 |  |  | 1,309,107 |  |  | (13,565) |  |  | (1,094,872) |  |  | 200,790 |  |  | 0 |  |  | 200,790 |  |
Balance (in shares) at Dec. 31, 2015 | 120,351 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Increase (Decrease) in Stockholders' Equity [Roll Forward] |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Net income (loss) | $ 0 |  |  | 0 |  |  | 0 |  |  | (60,400) |  |  | (60,400) |  |  | 0 |  |  | (60,400) |  |
Change in unrealized gains (losses), net of tax | 0 |  |  | 0 |  |  | (16,772) |  |  | 0 |  |  | (16,772) |  |  | 0 |  |  | (16,772) |  |
Foreign currency translation | 0 |  |  | 0 |  |  | (21) |  |  | 0 |  |  | (21) |  |  | 0 |  |  | (21) |  |
Issuance of common stock in connection with employee stock plans | $ 2 |  |  | 13,706 |  |  | 0 |  |  | 0 |  |  | 13,708 |  |  | 0 |  |  | 13,708 |  |
Issuance of common stock in connection with employee stock plans (in shares) | 1,285 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
2 3/4 percent convertible senior notes redemption, equity portion | $ 0 |  |  | (128,888) |  |  | 0 |  |  | 0 |  |  | (128,888) |  |  | 0 |  |  | (128,888) |  |
1 percent convertible senior notes, equity portion, net of issuance costs | 0 |  |  | 43,335 |  |  | 0 |  |  | 0 |  |  | 43,335 |  |  | 0 |  |  | 43,335 |  |
Stock-based compensation expense | 0 |  |  | 72,108 |  |  | 0 |  |  | 0 |  |  | 72,108 |  |  | 0 |  |  | 72,108 |  |
Noncontrolling interest in Akcea Therapetuics, Inc. |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 0 |  |
Excess tax benefits from stock-based compensation awards | 0 |  |  | 1,861 |  |  | 0 |  |  | 0 |  |  | 1,861 |  |  | 0 |  |  | 1,861 |  |
Balance at Dec. 31, 2016 | $ 122 |  |  | 1,311,229 |  |  | (30,358) |  |  | (1,241,380) |  |  | 39,613 |  |  | 0 |  |  | 39,613 |  |
Balance (in shares) at Dec. 31, 2016 | 121,636 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Increase (Decrease) in Stockholders' Equity [Roll Forward] |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Net income (loss) | $ 0 |  |  | 0 |  |  | 0 |  |  | 346 |  |  | 346 |  |  | 0 |  |  | 346 |  |
Change in unrealized gains (losses), net of tax | 0 |  |  | 0 |  |  | (1,334) |  |  | 0 |  |  | (1,334) |  |  | 0 |  |  | (1,334) |  |
Foreign currency translation | 0 |  |  | 0 |  |  | (67) |  |  | 0 |  |  | (67) |  |  | 0 |  |  | (67) |  |
Stock purchase |  | $ 2 |  |  | $ 71,737 |  |  | $ 0 |  |  | $ 0 |  |  | $ 71,739 |  |  | $ 0 |  |  | $ 71,739 |
Stock purchase (in shares) |  | 1,631 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Issuance of common stock in connection with employee stock plans | $ 1 |  |  | 22,931 |  |  | 0 |  |  | 0 |  |  | 22,932 |  |  | 0 |  |  | 22,932 |  |
Issuance of common stock in connection with employee stock plans (in shares) | 1,709 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Stock-based compensation expense | $ 0 |  |  | 85,975 |  |  | 0 |  |  | 0 |  |  | 85,975 |  |  | 0 |  |  | 85,975 |  |
Issuance of Akcea Therapeutics, Inc. common stock in conjunction with intial public offering | $ 0 |  |  | 157,270 |  |  | 0 |  |  | 0 |  |  | 157,270 |  |  | 0 |  |  | 157,270 |  |
Issuance of Akcea Therapeutics, Inc. common stock in conjunction with intial public offering (in shares) | 0 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Noncontrolling interest in Akcea Therapeutics, Inc. in conjunction with initial public offering | $ 0 |  |  | (90,351) |  |  | 0 |  |  | 0 |  |  | (90,351) |  |  | 90,381 |  |  | 30 |  |
Noncontrolling interest in Akcea Therapetuics, Inc. | 0 |  |  | (5,110) |  |  | 0 |  |  | 0 |  |  | (5,110) |  |  | (6,114) |  |  | (11,224) |  |
Balance at Dec. 31, 2017 | $ 125 |  |  | 1,553,681 |  |  | (31,759) |  |  | (1,241,034) |  |  | 281,013 |  |  | 84,267 |  |  | 365,280 |  |
Balance (in shares) at Dec. 31, 2017 | 124,976 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Increase (Decrease) in Stockholders' Equity [Roll Forward] |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Net income (loss) | $ 0 |  |  | 0 |  |  | 0 |  |  | 273,741 |  |  | 273,741 |  |  | 0 |  |  | 273,741 |  |
Change in unrealized gains (losses), net of tax | 0 |  |  | 0 |  |  | (280) |  |  | 0 |  |  | (280) |  |  | 0 |  |  | (280) |  |
Foreign currency translation | 0 |  |  | 0 |  |  | 23 |  |  | 0 |  |  | 23 |  |  | 0 |  |  | 23 |  |
Stock purchase |  |  | $ 11 |  |  | $ 447,954 |  |  | $ 0 |  |  | $ 0 |  |  | $ 447,965 |  |  | $ 0 |  |  | $ 447,965
Stock purchase (in shares) |  |  | 11,502 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Issuance of common stock in connection with employee stock plans | $ 2 |  |  | 27,898 |  |  | 0 |  |  | 0 |  |  | 27,900 |  |  | 0 |  |  | 27,900 |  |
Issuance of common stock in connection with employee stock plans (in shares) | 1,451 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
Stock-based compensation expense | $ 0 |  |  | 131,312 |  |  | 0 |  |  | 0 |  |  | 131,312 |  |  | 0 |  |  | 131,312 |  |
Noncontrolling interest in Akcea Therapetuics, Inc. | 0 |  |  | (113,595) |  |  | 0 |  |  | 0 |  |  | (113,595) |  |  | 54,814 |  |  | (58,781) |  |
Balance at Dec. 31, 2018 | $ 138 |  |  | $ 2,047,250 |  |  | $ (32,016) |  |  | $ (967,293) |  |  | $ 1,048,079 |  |  | $ 139,081 |  |  | $ 1,187,160 |  |
Balance (in shares) at Dec. 31, 2018 | 137,929 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |

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