Depends on what you are trying to do with it and the flow rate. For algae control, your mileage varies dramatically. With a properly rated UV, it's very beneficial for controlling pests like flatworms, aptaisia, and ich. If it is undersized, or flow is too fast, then it's effectiveness takes a nosedive.
My personal opinion is that they are a good investment for fish only systems. For reef systems, it's a case by case basis.