Americans who watch at least a few hours of TV each week are used to getting urged to ask their doctors about all sorts of medications that, chances are, they really don’t need.  

Most have learned to tune out the incessant reminders about pharmaceutical helps for relatively routine conditions like high cholesterol and acid reflux. And it seems reasonable to assume that a lot of mute buttons get a good workout thanks to the sound of the words “erectile dysfunction.”

But now the inescapable drug-ad onslaught includes campaigns for meds to counter such decidedly uncommon conditions as sleep difficulties in blind people and squamous non-small cell lung cancer.

The Wall Street Journal took a look at the development Feb. 16.

On one side of the story are the drug companies spending the big bucks to reach niche patient populations.

Mihael Polymeropoulos, CEO of Vanda Pharmaceuticals, the company behind the drug for blindness-related sleep disorder—which rings up an annual tab of nearly $150,000—says awareness of the problem is low while the potential to relieve suffering is high.

“We would have rather avoided the expense of a campaign, but there was no other efficient way of doing it,” he told the Journal, adding that more than 12,000 individuals have responded by requesting more information.

On the other side are physician and consumer groups that would like to see some restraint—by force of federal regulation, if needed.

The article cites a call for a ban on consumer spots sounded by the American Medical Association last November. The AMA says the proliferation of direct-to-consumer drug ads “is driving demand for expensive treatments despite the clinical effectiveness of less costly alternatives.”

How big has the explosion been? TV ad spending by drugmakers spiked 23 percent from 2014 to 2015, hitting $2.4 billion in the first nine months of the year, the article reports.

The argument gets interesting in the comment boxes, where colorful comments abound.

“These drug ads pointedly exclude less expensive options that work very well,” one reader writes. “After mentioning, in a low monotone, the many ways the drug may kill you, every ad has a happy smiley faced ending. It’s all designed to get patients to nag their doctors into prescribing stuff that’s against their better judgement.”

“The ads are meant to start conversations with your doctor. That doesn’t seem like a bad thing,” counters another reader. “After I landed in Urgent Care four times last year with breathing difficulties, my allergist prescribed Symbicort. I knew what it was. I’d seen the ads.”