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Significant Accounting Policies, Convertible Debt (Details) $ / shares in Units, $ in Thousands | 3 Months Ended | 9 Months Ended |  |  |  |  |
--- | --- | --- | --- | --- | --- | --- | ---
Sep. 30, 2021 USD ($) Note $ / shares | Sep. 30, 2020 USD ($) $ / shares | Sep. 30, 2021 USD ($) Note $ / shares | Sep. 30, 2020 USD ($) $ / shares | Jun. 30, 2021 USD ($) | Apr. 30, 2021 USD ($) | Dec. 31, 2020 USD ($) | Jun. 30, 2020 USD ($) | Dec. 31, 2019 USD ($)
Convertible Debt [Abstract] |  |  |  |  |  |  |  |  |
Number of outstanding convertible notes | Note | 2 |  | 2 |  |  |  |  |  |
Condensed Consolidated Balance Sheet [Abstract] |  |  |  |  |  |  |  |  |
1 percent convertible senior notes, net | $ 61,936 |  | $ 61,936 |  |  |  | $ 308,809 |  |
Additional paid-in capital | 1,942,348 |  | 1,942,348 |  |  |  | 1,895,519 |  |
Accumulated deficit | (1,384,516) |  | (1,384,516) |  |  |  | (1,131,306) |  |
Condensed Consolidated Statement of Operations [Abstract] |  |  |  |  |  |  |  |  |
Interest expense | (2,340) | $ (2,428) | (7,111) | $ (7,076) |  |  |  |  |
Loss before income tax benefit (expense) | (83,773) | (31,550) | (254,064) | (119,979) |  |  |  |  |
Income tax benefit (expense) | 1,307 | (5,064) | 854 | (4,077) |  |  |  |  |
Net loss | (82,466) | (36,614) | (253,210) | (124,056) |  |  |  |  |
Net loss attributable to Ionis Pharmaceuticals, Inc. common stockholders | $ (82,466) | $ (24,467) | $ (253,210) | $ (89,731) |  |  |  |  |
Basic net loss per share (in dollars per share) | $ / shares | $ (0.58) | $ (0.18) | $ (1.80) | $ (0.64) |  |  |  |  |
Diluted net loss per share (in dollars per share) | $ / shares | $ (0.58) | $ (0.18) | $ (1.80) | $ (0.64) |  |  |  |  |
Condensed Consolidated Statements of Stockholders' Equity [Abstract] |  |  |  |  |  |  |  |  |
Balance | $ 530,536 | $ 1,520,579 | $ 530,536 | $ 1,520,579 | $ 582,674 |  | 743,282 | $ 1,502,513 | $ 1,577,458
Additional Paid In Capital [Member] |  |  |  |  |  |  |  |  |
Condensed Consolidated Statement of Operations [Abstract] |  |  |  |  |  |  |  |  |
Net loss attributable to Ionis Pharmaceuticals, Inc. common stockholders | 0 | 0 | 0 | 0 |  |  |  |  |
Condensed Consolidated Statements of Stockholders' Equity [Abstract] |  |  |  |  |  |  |  |  |
Balance | 1,942,348 | 2,093,551 | 1,942,348 | 2,093,551 | 1,910,379 |  | 1,895,519 | 2,053,502 | 1,985,650
Accumulated Deficit [Member] |  |  |  |  |  |  |  |  |
Condensed Consolidated Statement of Operations [Abstract] |  |  |  |  |  |  |  |  |
Net loss attributable to Ionis Pharmaceuticals, Inc. common stockholders | (82,466) | (24,467) | (253,210) | (89,731) |  |  |  |  |
Condensed Consolidated Statements of Stockholders' Equity [Abstract] |  |  |  |  |  |  |  |  |
Balance | (1,384,516) | (776,775) | (1,384,516) | (776,775) | (1,302,050) |  | (1,131,306) | (752,308) | (596,495)
Total Ionis Stockholders' Equity [Member] |  |  |  |  |  |  |  |  |
Condensed Consolidated Statement of Operations [Abstract] |  |  |  |  |  |  |  |  |
Net loss attributable to Ionis Pharmaceuticals, Inc. common stockholders | (82,466) | (24,467) | (253,210) | (89,731) |  |  |  |  |
Condensed Consolidated Statements of Stockholders' Equity [Abstract] |  |  |  |  |  |  |  |  |
Balance | $ 530,536 | $ 1,297,344 | $ 530,536 | $ 1,297,344 | $ 582,674 |  | $ 743,282 | $ 1,284,893 | 1,364,005
0.125 Percent Convertible Senior Notes [Member] |  |  |  |  |  |  |  |  |
Convertible Debt [Abstract] |  |  |  |  |  |  |  |  |
Interest rate on convertible senior notes | 0.125% | 0.125% | 0.125% | 0.125% |  |  | 0.125% |  |
Condensed Consolidated Balance Sheet [Abstract] |  |  |  |  |  |  |  |  |
Convertible senior notes | $ 541,768 |  | $ 541,768 |  |  |  | $ 540,136 |  |
Condensed Consolidated Statement of Operations [Abstract] |  |  |  |  |  |  |  |  |
Effective interest rate | 0.50% |  | 0.50% |  |  |  |  |  |
1 Percent Convertible Senior Notes [Member] |  |  |  |  |  |  |  |  |
Convertible Debt [Abstract] |  |  |  |  |  |  |  |  |
Interest rate on convertible senior notes | 1.00% | 1.00% | 1.00% | 1.00% |  |  | 1.00% |  |
Condensed Consolidated Statement of Operations [Abstract] |  |  |  |  |  |  |  |  |
Effective interest rate | 1.40% |  | 1.40% |  |  |  |  |  |
0 Percent Convertible Senior Notes [Member] |  |  |  |  |  |  |  |  |
Convertible Debt [Abstract] |  |  |  |  |  |  |  |  |
Interest rate on convertible senior notes | 0.00% |  | 0.00% |  |  |  |  |  |
Face amount of offering |  |  |  |  |  | $ 632,500 |  |  |
Condensed Consolidated Balance Sheet [Abstract] |  |  |  |  |  |  |  |  |
Convertible senior notes | $ 618,341 |  | $ 618,341 |  |  |  | $ 0 |  |
Condensed Consolidated Statement of Operations [Abstract] |  |  |  |  |  |  |  |  |
Effective interest rate | 0.50% |  | 0.50% |  |  |  |  |  |
As Previously Reported [Member] |  |  |  |  |  |  |  |  |
Condensed Consolidated Balance Sheet [Abstract] |  |  |  |  |  |  |  |  |
1 percent convertible senior notes, net |  |  |  |  |  |  | 293,161 |  |
Additional paid-in capital |  |  |  |  |  |  | 2,113,646 |  |
Accumulated deficit |  |  |  |  |  |  | (1,249,368) |  |
Condensed Consolidated Statement of Operations [Abstract] |  |  |  |  |  |  |  |  |
Interest expense |  | $ (11,321) |  | $ (33,484) |  |  |  |  |
Loss before income tax benefit (expense) |  | (40,443) |  | (146,387) |  |  |  |  |
Income tax benefit (expense) |  | (2,648) |  | 1,047 |  |  |  |  |
Net loss |  | (43,091) |  | (145,340) |  |  |  |  |
Net loss attributable to Ionis Pharmaceuticals, Inc. common stockholders |  | $ (30,944) |  | $ (111,015) |  |  |  |  |
Basic net loss per share (in dollars per share) | $ / shares |  | $ (0.22) |  | $ (0.80) |  |  |  |  |
Diluted net loss per share (in dollars per share) | $ / shares |  | $ (0.22) |  | $ (0.80) |  |  |  |  |
Condensed Consolidated Statements of Stockholders' Equity [Abstract] |  |  |  |  |  |  |  |  |
Balance |  |  |  |  |  |  | 843,347 |  | 1,684,547
As Previously Reported [Member] | Additional Paid In Capital [Member] |  |  |  |  |  |  |  |  |
Condensed Consolidated Statements of Stockholders' Equity [Abstract] |  |  |  |  |  |  |  |  |
Balance |  |  |  |  |  |  | 2,113,646 |  | 2,203,778
As Previously Reported [Member] | Accumulated Deficit [Member] |  |  |  |  |  |  |  |  |
Condensed Consolidated Statements of Stockholders' Equity [Abstract] |  |  |  |  |  |  |  |  |
Balance |  |  |  |  |  |  | (1,249,368) |  | (707,534)
As Previously Reported [Member] | 0.125 Percent Convertible Senior Notes [Member] |  |  |  |  |  |  |  |  |
Condensed Consolidated Balance Sheet [Abstract] |  |  |  |  |  |  |  |  |
Convertible senior notes |  |  |  |  |  |  | 455,719 |  |
Adjustment [Member] | ASU 2020-06 [Member] |  |  |  |  |  |  |  |  |
Condensed Consolidated Balance Sheet [Abstract] |  |  |  |  |  |  |  |  |
1 percent convertible senior notes, net |  |  |  |  |  |  | 15,648 |  |
Additional paid-in capital |  |  |  |  |  |  | (218,127) |  |
Accumulated deficit |  |  |  |  |  |  | 118,062 |  |
Net deferred tax assets |  |  |  |  |  |  | 0 |  |
Condensed Consolidated Statement of Operations [Abstract] |  |  |  |  |  |  |  |  |
Interest expense |  | $ 8,893 |  | $ 26,408 |  |  |  |  |
Loss before income tax benefit (expense) |  | 8,893 |  | 26,408 |  |  |  |  |
Income tax benefit (expense) |  | (2,416) |  | (5,124) |  |  |  |  |
Net loss |  | 6,477 |  | 21,284 |  |  |  |  |
Net loss attributable to Ionis Pharmaceuticals, Inc. common stockholders |  | $ 6,477 |  | $ 21,284 |  |  |  |  |
Basic net loss per share (in dollars per share) | $ / shares |  | $ 0.04 |  | $ 0.16 |  |  |  |  |
Diluted net loss per share (in dollars per share) | $ / shares |  | $ 0.04 |  | $ 0.16 |  |  |  |  |
Condensed Consolidated Statements of Stockholders' Equity [Abstract] |  |  |  |  |  |  |  |  |
Balance |  |  |  |  |  |  | (100,065) |  | (107,089)
Adjustment [Member] | ASU 2020-06 [Member] | Additional Paid In Capital [Member] |  |  |  |  |  |  |  |  |
Condensed Consolidated Statements of Stockholders' Equity [Abstract] |  |  |  |  |  |  |  |  |
Balance |  |  |  |  |  |  | (218,127) |  | (218,128)
Adjustment [Member] | ASU 2020-06 [Member] | Accumulated Deficit [Member] |  |  |  |  |  |  |  |  |
Condensed Consolidated Statements of Stockholders' Equity [Abstract] |  |  |  |  |  |  |  |  |
Balance |  |  |  |  |  |  | 118,062 |  | $ 111,039
Adjustment [Member] | ASU 2020-06 [Member] | 0.125 Percent Convertible Senior Notes [Member] |  |  |  |  |  |  |  |  |
Condensed Consolidated Balance Sheet [Abstract] |  |  |  |  |  |  |  |  |
Convertible senior notes |  |  |  |  |  |  | $ 84,417 |  |

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