X0306 4 2020-01-15 0000874015 IONIS PHARMACEUTICALS INC IONS 0001537529 Monia Brett P C/O IONIS PHARMACEUTICALS, INC. 2855 GAZELLE COURT CARLSBAD CA 92010 1 1 0 0 Chief Executive Officer Common Stock 2020-01-15 2020-01-15 4 M 0 19921 0 A 36206 D Common Stock 2020-01-15 2020-01-15 4 F 0 7563 62.06 D 28643 D Restricted Stock Units 2020-01-15 2020-01-15 4 A 0 65979 0 A Common Stock 65979 65979 D Performance Restricted Stock Units 2020-01-15 2020-01-15 4 A 0 17009 0 A Common Stock 17009 17009 D Restricted Stock Units 2020-01-15 2020-01-15 4 M 0 19921 0 D Common Stock 19921 46087 D Acquired pursuant to vesting and release of shares in accordance with Restricted Stock Unit awards. Shares withheld to cover the required tax withholding obligations pursuant to the Ionis Pharmaceuticals, Inc. Amended and Restated 2011 Equity Incentive Plan. Grant to reporting person of Restricted Stock Units under the Ionis Pharmaceuticals, Inc. Amended and Restated 2011 Equity Incentive Plan. Each Restricted Stock Unit represents a contingent right to receive one share of Ionis common stock, or its equivalent cash value. Restricted Stock Units vest in four equal annual installments. Upon vesting, the Restricted Stock Units will be paid out in whole shares of Ionis common stock or cash as may be determined by Ionis. Represents an award of performance based restricted stock units ("PRSUs"). One-third of the PRSUs may vest at the end of three separate performance periods spread over the three years following the date of grant based on the Issuer's relative total shareholder return as compared to a peer group of companies. The number of PRSUs reported represents the maximum that may be earned, which is 150% of the target number. No number of PRSUs is guaranteed to vest and the actual number of PRSUs that will vest at the end of each performance period may be anywhere from zero to the amount stated. Grant to reporting person of Performance Restricted Stock Units under the Ionis Pharmaceuticals, Inc. Amended and Restated 2011 Equity Incentive Plan. /s/Patrick R. O'Neil, attorney-in-fact 2020-01-17