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Fourth Quarter Financial Data (Unaudited) (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands | 3 Months Ended | 12 Months Ended |  |
--- | --- | --- | --- | ---
Dec. 31, 2022 | Dec. 31, 2021 | Dec. 31, 2022 | Dec. 31, 2021 | Dec. 31, 2020 | Apr. 30, 2021 | Dec. 31, 2019
Fourth Quarter Financial Data (Unaudited) [Abstract] |  |  |  |  |  |  |  |  |
Revenue | $ 151,890 | [1] | $ 440,006 |  |  |  |  |  |
Operating expenses | 359,909 | [2] | 219,403 |  | $ 997,558 | $ 840,642 | $ 901,346 |  |
Loss from operations | (208,019) |  | 220,603 |  | (410,191) | (30,186) | (172,082) |  |
Net income (loss) | $ (52,430) | [3] | $ 224,613 |  | $ (269,722) | $ (28,597) | $ (479,743) |  |
Basic net income (loss) per share (in dollars per share) | $ (0.37) | [4],[5] | $ 1.59 | [4],[5] | $ (1.9) | $ (0.2) | $ (3.18) |  |
Diluted net income (loss) per share (in dollars per share) | $ (0.37) | [4] | $ 1.41 | [4],[6] | $ (1.9) | $ (0.2) | $ (3.18) |  |
Gain on sale of real estate assets | $ 150,100 |  |  |  | $ 150,135 | $ 0 | $ 0 |  |
Income (Numerator) [Abstract] |  |  |  |  |  |  |  |  |
Income (loss) available to Ionis common stockholders |  |  | $ 224,612 |  |  |  | $ (444,464) |  |
Net income available to Ionis common shareholders |  |  | $ 226,210 |  |  |  |  |  |
Shares (Denominator) [Abstract] |  |  |  |  |  |  |  |  |
Shares used in computing basic net loss per share (in shares) |  |  | 141,205 |  | 141,848 | 141,021 | 139,612 |  |
Effect of Diluted Securities [Abstract] |  |  |  |  |  |  |  |  |
Shares issuable related to our ESPP (in shares) |  |  | 34 |  |  |  |  |  |
Shares used in computing diluted net income per share (in shares) |  |  | 160,340 |  | 141,848 | 141,021 | 139,612 |  |
0 Percent Convertible Senior Notes [Member] |  |  |  |  |  |  |  |  |
Fourth Quarter Financial Data (Unaudited) [Abstract] |  |  |  |  |  |  |  |  |
Interest rate on convertible senior notes | 0.00% |  | 0.00% |  | 0.00% | 0.00% |  | 0.00% | 0.00%
Income (Numerator) [Abstract] |  |  |  |  |  |  |  |  |
Shares issuable related to our convertible notes |  |  | $ 777 |  |  |  |  |  |
Effect of Diluted Securities [Abstract] |  |  |  |  |  |  |  |  |
Shares issuable related to our convertible notes (in shares) |  |  | 10,936 |  |  |  |  |  |
0.125 Percent Convertible Senior Notes [Member] |  |  |  |  |  |  |  |  |
Fourth Quarter Financial Data (Unaudited) [Abstract] |  |  |  |  |  |  |  |  |
Interest rate on convertible senior notes | 0.125% |  | 0.125% |  | 0.125% | 0.125% | 0.125% |  | 0.125%
Income (Numerator) [Abstract] |  |  |  |  |  |  |  |  |
Shares issuable related to our convertible notes |  |  | $ 716 |  |  |  |  |  |
Effect of Diluted Securities [Abstract] |  |  |  |  |  |  |  |  |
Shares issuable related to our convertible notes (in shares) |  |  | 6,590 |  |  |  |  |  |
1 Percent Convertible Senior Notes [Member] |  |  |  |  |  |  |  |  |
Fourth Quarter Financial Data (Unaudited) [Abstract] |  |  |  |  |  |  |  |  |
Interest rate on convertible senior notes | 1.00% |  | 1.00% |  | 1.00% | 1.00% | 1.00% | 1.00% | 1.00%
Income (Numerator) [Abstract] |  |  |  |  |  |  |  |  |
Shares issuable related to our convertible notes |  |  | $ 105 |  |  |  |  |  |
Effect of Diluted Securities [Abstract] |  |  |  |  |  |  |  |  |
Shares issuable related to our convertible notes (in shares) |  |  | 464 |  |  |  |  |  |
Stock Options [Member] |  |  |  |  |  |  |  |  |
Effect of Diluted Securities [Abstract] |  |  |  |  |  |  |  |  |
Shares issuable related to stock-based compensation (in shares) |  |  | 46 |  |  |  |  |  |
Restricted Stock Awards [Member] |  |  |  |  |  |  |  |  |
Effect of Diluted Securities [Abstract] |  |  |  |  |  |  |  |  |
Shares issuable related to stock-based compensation (in shares) |  |  | 1,065 |  |  |  |  |  |
Eplontersen Collaboration [Member] |  |  |  |  |  |  |  |  |
Fourth Quarter Financial Data (Unaudited) [Abstract] |  |  |  |  |  |  |  |  |
Revenue |  |  | $ 200,000 |  |  |  |  |  |
Metagenomi License Agreement [Member] |  |  |  |  |  |  |  |  |
Fourth Quarter Financial Data (Unaudited) [Abstract] |  |  |  |  |  |  |  |  |
Upfront payment | $ 80,000 |  |  |  |  |  |  |  |
[1] | Revenue was lower in the three months ended December 31, 2022 compared to the same period in 2021 due to the $200 million we earned in the fourth quarter of 2021 from AstraZeneca to jointly develop and commercialize eplontersen.
[2] | Operating expenses were higher in the three months ended December 31, 2022 compared to the same period in 2021 primarily due to the $80 million upfront payment we made for our collaboration with Metagenomi in the fourth quarter of 2022.
[3] | Our net loss for the three months ended December 31, 2022 includes the $150.1 million gain we recognized from the sale and leaseback transaction for our headquarters in Carlsbad, California.
[4] | We compute net income (loss) per share independently for each quarter during the year.
[5] | As discussed in Note 1, Organization and Significant Accounting Policies, we compute basic net income (loss) per share by dividing the total net income (loss) by our weighted-average number of common shares outstanding during the period.
[6] | We had net income for the fourth quarter of 2021. As a result, we computed diluted net income per share using the weighted-average number of common shares and dilutive common equivalent shares outstanding during the period

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