Been running various setups over the last decade across boat, motorhome, and narrowboat, and I'd say it matters more than folk initially think—but context is everything.
On the boat with modest power draw (mostly LED lighting, fridge, occasional power tools), I went budget route with a cheap 1500W Chinese inverter. Lost maybe 8-10% efficiency, but annual waste was negligible given usage patterns. Not worth upgrading.
The motorhome's different story. I'm running a 3000W Victron MultiPlus daily for water heater, microwave, occasional workshop equipment. At 96-97% efficiency, that extra 1-2% versus cheaper alternatives compounds across constant use. Over a year, you're talking meaningful battery drain or increased solar panel capacity needed to compensate.
Where efficiency really bites is part-load operation. Most inverters tank below 50% rated capacity. If you're sizing a 5kW unit but only drawing 500W typical load, you might see 70-75% efficiency. That's where undersizing intelligently helps—smaller inverters often run closer to their sweet spot.
The calculus shifts depending on whether you're grid-tied (less critical) or fully off-grid (every watt matters). Battery capacity is expensive; if a £300 premium on a quality unit saves you adding another 10kWh of storage, it's financially sound.
What's your typical load profile and power source? That'll dictate whether efficiency gains justify the outlay. Some setups genuinely don't need premium gear; others absolutely do.