We have a multi-AZ production deployment with AWS RDS and it's been working fabulously well for the last 3 years.
The multi-AZ catalog page clearly lists out the benefit of using a multi-az vs single RDS deployment. One of the most important aspects of running multi-az is the fact that if one of the AZ in a region goes down, the production application traffic is automatically routed to the RDS in the alternate AZ. Also, DB maintenance and upgrades are applied to the RDS per AZ basis (for a multi-AZ RDS) without impacting uptime.
With respect to cost, it is totally up to the nature of the application as to how much is the degree of downtime tolerance that it can sustain. It's a cost vs uptime trade-off.