I user Refactor! all the time. Just the time it saves me to encapsulate private variables into properties is worth it in my opinion.
That being said... a lot of the "benefits" of these programs are negated if you program it correctly to begin with.
For example, if you already habitually use "WITH" statements properly, you probably do not need something to clean up your style.
However in corporate America (and elsewhere I am sure), coding practices are not always followed by everyone, and rework and modifications are always coming in, so usually you will end up needing them eventually.
I personally have not experienced any noticeable difference in performance with these type of tools.