They are good at killing near anything free-floating in the water, be that a parasite, algae, bacteria whatever. But, the thing has to flow through the chamber where it is exposed to the light -- in other words it will never be able to kill off 100% of the nasties in the water. It will increase the death rate, and the population will decrease until the birth rate and death rate are equal, but the population can never be reduced to exactly zero.
Other drawbacks are cost -- bulbs need to be replaced frequently as they stop producing the radiation they use after some time, the flow chamber has to be kept clean. There seems to be anecdotal evidence that the water can be too clean, that is the fish's immune system is weakened because everything in the water is killed off and the immune system stops working. I have my doubts about that statement, but it has been said.
To me, they are pretty unnecessary if you do the maintenance that you know you are supposed to do. I would consider them if you want to keep a particularly valuable, rare fish safer, but if you do all the things that have worked for fishkeepers for decades (quarantine, water changes, etc.), then they become little more than expensive toys.