I don't even do particularly intense hikes, usually not even overnight, but I read a few stories and realised how easy it is to end up in a situation where you need one. You just have to slip over and land badly, that's all it takes.
Or maybe it won't be me, but someone else on the trail who needs help.
The "Into the Wild" bus comes to mind[1]. So many people died every year, attempting to forge rivers unprepared, and brave the harsh Alaskan elements, that they had to remove this bus! It wasn't enough that people died every year, and that most of them had practically zero harsh environment experience...
Nature will kill you every chance it gets. Be prepared, or don't go.
These things are also regulated by the government and need to meet certain standards.
People will spend thousands of dollars on ultralight gear, and then balk at $300 for a magic button that summons a helicopter when you have a broken leg.
It's literally the cheapest life insurance you will ever be able to buy.
As of a decade ago, incorrect airbag deployment killed one person for ever 7 lives it saved. Nonetheless, they were mandated by law for many classes of cars, and were purchased voluntarily for others. And this was the right decision. They could have spent thousands of dollars per unit to get the mistake rate even lower, but that wouldn't have been worth the money.
I do find it somewhat amusing to read a comment that a device that locates me anywhere on the planet and can communicate that information via satellite costs a few hundred dollars! to be vaguely amusing.
These devices tend to be expensive because most of them are manufactured to either FAA or Coast Guard standards that are pretty strict and require things like a multi-year permanent battery, water intrusion and impact tests, etc.
On the other hand you can get a couple of different consumer-pointing satellite communicators that rely on commercial networks, mostly GlobalStar. Spot X and Garmin InReach are the two big ones. Both are cheaper up front but require a monthly service plan. They do tend to have fancy features that PLBs can't offer like two-way text messaging, but they're not generally built to any particular standard for durability, so you wouldn't want to use them, say, at sea or in an airplane.
The COSPAS-SARSAT system also generally has better coverage than GlobalStar but there are tradeoffs, esp. depending on the different capability levels.
The thought that they're pricey seems like a reasonable thing when you compare e.g. a $400 EPIRB to the $200 Spot X, but the EPIRB is tested to work in water whereas the Spot X has janky firmware that doesn't always work great anywhere (I love mine but... it has rough edges).
These are different though. SPOT works on globalstar which has gaps in coverage, particularly large parts of the Pacific. A coverage map is here: https://www.findmespot.com/en-us/products-services/coverage-...
The inReach works on iridum and claims 100% world-wide coverage.
Personally I carry an EPIRB for the boat, a PLB on the lifejacket and an inReach for texting. Cheap insurance.
Basically, if you can afford it, it works. If you can’t afford it, satellite comms might not have saved you anyway, even if you had it.
A satellite text messenger like SPOT is not a PLB.
I like to go places with no cell signal, and when you're hours from the nearest paved road, it's nice to know that you can get airlifted out if you get bitten by a snake, etc.