UV sterilizers are a great tool to combat parasites, bacteria, viruses, and free-floating algaes which cause green tank syndrome. They are in no way a tool to treat disease, only a tool to prevent the spread of disease. They also do not take the place of proper QT methods and do not eliminate the need to care for sick fish thru isolation and medicine/hypo.
However, with that being said, UV sterilization will eliminate 99.9% of all pathogens which pass thru the light. It is important to not exceed the flow rate of the specific sterilizer you purchase, as exposure time to the UV is important. Hospitals use UV sterilizers in their air systems (I also have them in my air system at my house) and water treatment plants use them to eliminate E. coli from water.
It is true that even beneficial bacteria in your tank will be killed, but since the majority of this lives in your sand and on your rocks, it really doesn't matter. It can also zap the occasional copepod, but again, negligible. I run an Aqua Medic 18W sterilizer 24/7 on my reef; I have over 60 types of corals and have been doing this for at least six years with a sterilizer and have never had a single problem.
Are they absolutely required? Debatable. Fish always carry ich, so a bout of stress could lead to an outbreak. They way I look at it is that if the worst case scenario happens, I want to have as many tools at my disposal as possible. I'm also putting in a jellyfish tank here in the next coupla months and I will be installing a UV sterilizer to combat hydroids.