My Alfine setup has been almost trouble free since 2006.
I had some issues with grease sticking the gears at -10C, cured by switching to annual oil-bath.
I have changed the cable once, with no issues.
It is probably not a piece of kit for performance hounds, but serves just fine for everyday commuting and utility riding in the city.
I used to play my downtube friction-levers like a concert violinist, but things are so much easier and I am lazier now. Alfine frees up my concentration so I can pay more attention to the traffic, road-conditions, pretty girls, whatever.