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CONDENSED CONSOLIDATED STATEMENTS OF STOCKHOLDERS' EQUITY - USD ($) shares in Thousands, $ in Thousands | Common Stock [Member] | Additional Paid In Capital [Member] | Accumulated Other Comprehensive Loss [Member] | Accumulated Deficit [Member] | Total Ionis Stockholders' Equity [Member] | Noncontrolling Interest in Akcea Therapeutics, Inc. [Member] | Total
--- | --- | --- | --- | --- | --- | --- | ---
Balance at Dec. 31, 2019 | $ 140 | $ 1,985,650 | $ (25,290) | $ (596,495) | $ 1,364,005 | $ 213,453 | $ 1,577,458
Balance (in shares) at Dec. 31, 2019 | 140,340 |  |  |  |  |  |
Increase (Decrease) in Stockholders' Equity [Roll Forward] |  |  |  |  |  |  |
Net loss | $ 0 | 0 | 0 | (89,731) | (89,731) | 0 | (89,731)
Change in unrealized gains (losses), net of tax | 0 | 0 | 5,803 | 0 | 5,803 | 0 | 5,803
Foreign currency translation | 0 | 0 | 357 | 0 | 357 | 0 | 357
Issuance of common stock in connection with employee stock plans | $ 1 | 29,449 | 0 | 0 | 29,450 | 0 | 29,450
Issuance of common stock in connection with employee stock plans (in shares) | 1,141 |  |  |  |  |  |
Repurchases and retirements of common stock | $ (1) | 0 | 0 | (90,549) | (90,550) | 0 | (90,550)
Repurchases and retirements of common stock (in shares) | (1,478) |  |  |  |  |  |
Stock-based compensation expense | $ 0 | 135,077 | 0 | 0 | 135,077 | 0 | 135,077
Payments of tax withholdings related to vesting of employee stock awards and exercise of employee stock options | $ 0 | (12,960) | 0 | 0 | (12,960) | 0 | (12,960)
Payments of tax withholdings related to vesting of employee stock awards and exercise of employee stock options (in shares) | (209) |  |  |  |  |  |
Noncontrolling interest in Akcea Therapeutics, Inc. | $ 0 | (43,665) | (442) | 0 | (44,107) | 9,782 | (34,325)
Balance at Sep. 30, 2020 | $ 140 | 2,093,551 | (19,572) | (776,775) | 1,297,344 | 223,235 | 1,520,579
Balance (in shares) at Sep. 30, 2020 | 139,794 |  |  |  |  |  |
Balance at Jun. 30, 2020 | $ 139 | 2,053,502 | (16,440) | (752,308) | 1,284,893 | 217,620 | 1,502,513
Balance (in shares) at Jun. 30, 2020 | 139,489 |  |  |  |  |  |
Increase (Decrease) in Stockholders' Equity [Roll Forward] |  |  |  |  |  |  |
Net loss | $ 0 | 0 | 0 | (24,467) | (24,467) | 0 | (24,467)
Change in unrealized gains (losses), net of tax | 0 | 0 | (3,448) | 0 | (3,448) | 0 | (3,448)
Foreign currency translation | 0 | 0 | 275 | 0 | 275 | 0 | 275
Issuance of common stock in connection with employee stock plans | $ 1 | 12,997 | 0 | 0 | 12,998 | 0 | 12,998
Issuance of common stock in connection with employee stock plans (in shares) | 321 |  |  |  |  |  |
Stock-based compensation expense | $ 0 | 45,845 | 0 | 0 | 45,845 | 0 | 45,845
Payments of tax withholdings related to vesting of employee stock awards and exercise of employee stock options | $ 0 | (990) | 0 | 0 | (990) | 0 | (990)
Payments of tax withholdings related to vesting of employee stock awards and exercise of employee stock options (in shares) | (16) |  |  |  |  |  |
Noncontrolling interest in Akcea Therapeutics, Inc. | $ 0 | (17,803) | 41 | 0 | (17,762) | 5,615 | (12,147)
Balance at Sep. 30, 2020 | $ 140 | 2,093,551 | (19,572) | (776,775) | 1,297,344 | 223,235 | 1,520,579
Balance (in shares) at Sep. 30, 2020 | 139,794 |  |  |  |  |  |
Balance at Dec. 31, 2020 | $ 140 | 1,895,519 | (21,071) | (1,131,306) | 743,282 | 0 | 743,282
Balance (in shares) at Dec. 31, 2020 | 140,366 |  |  |  |  |  |
Increase (Decrease) in Stockholders' Equity [Roll Forward] |  |  |  |  |  |  |
Net loss | $ 0 | 0 | 0 | (253,210) | (253,210) | 0 | (253,210)
Change in unrealized gains (losses), net of tax | 0 | 0 | (6,321) | 0 | (6,321) | 0 | (6,321)
Foreign currency translation | 0 | 0 | (45) | 0 | (45) | 0 | (45)
Issuance of common stock in connection with employee stock plans | $ 1 | 11,563 | 0 | 0 | 11,564 | 0 | 11,564
Issuance of common stock in connection with employee stock plans (in shares) | 1,094 |  |  |  |  |  |
Issuance of warrants | $ 0 | 89,752 | 0 | 0 | 89,752 | 0 | 89,752
Purchase of note hedges | 0 | (136,620) | 0 | 0 | (136,620) | 0 | (136,620)
Stock-based compensation expense | 0 | 98,419 | 0 | 0 | 98,419 | 0 | 98,419
Payments of tax withholdings related to vesting of employee stock awards and exercise of employee stock options | $ 0 | (16,285) | 0 | 0 | (16,285) | 0 | (16,285)
Payments of tax withholdings related to vesting of employee stock awards and exercise of employee stock options (in shares) | (276) |  |  |  |  |  |
Balance at Sep. 30, 2021 | $ 141 | 1,942,348 | (27,437) | (1,384,516) | 530,536 | 0 | 530,536
Balance (in shares) at Sep. 30, 2021 | 141,184 |  |  |  |  |  |
Balance at Jun. 30, 2021 | $ 141 | 1,910,379 | (25,796) | (1,302,050) | 582,674 | 0 | 582,674
Balance (in shares) at Jun. 30, 2021 | 141,022 |  |  |  |  |  |
Increase (Decrease) in Stockholders' Equity [Roll Forward] |  |  |  |  |  |  |
Net loss | $ 0 | 0 | 0 | (82,466) | (82,466) | 0 | (82,466)
Change in unrealized gains (losses), net of tax | 0 | 0 | (1,618) | 0 | (1,618) | 0 | (1,618)
Foreign currency translation | 0 | 0 | (23) | 0 | (23) | 0 | (23)
Issuance of common stock in connection with employee stock plans | $ 0 | 1,922 | 0 | 0 | 1,922 | 0 | 1,922
Issuance of common stock in connection with employee stock plans (in shares) | 176 |  |  |  |  |  |
Stock-based compensation expense | $ 0 | 30,537 | 0 | 0 | 30,537 | 0 | 30,537
Payments of tax withholdings related to vesting of employee stock awards and exercise of employee stock options | $ 0 | (490) | 0 | 0 | (490) | 0 | (490)
Payments of tax withholdings related to vesting of employee stock awards and exercise of employee stock options (in shares) | (14) |  |  |  |  |  |
Balance at Sep. 30, 2021 | $ 141 | $ 1,942,348 | $ (27,437) | $ (1,384,516) | $ 530,536 | $ 0 | $ 530,536
Balance (in shares) at Sep. 30, 2021 | 141,184 |  |  |  |  |  |

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