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Maybe it has some value in pvp, since healing there is much more limited or even prevented by honor code, but idk.
Fun fact I never used any of the runes. :D
In PvP it does not work. Runes are disabled uppon invading. Plus, the window of opportunity to recover your health seems to be something between 2-4 seconds. And you only recover a little per hit. Can you imagine hitting someone 10 times to get your health back in PvP, in case you are the host? Also, most people use tear flasks in PvP anyway.
As far as I know it only lets you recover the portion of health you lost from the last hit, like in bloodborne, so yeah, I thought of it in a different type of manner for pvp. But, as you see, I haven't done much elden pvp yet.
Malenia's rune could have been the Rottent Winged Insignia effect (replaces talisman), and scarlet rot immunity.
I guess the great runes can be used based upon the fight your up against - changing it up before a boss room etc. However just like a health/mind scarabs it just feels like added content or specific use. You won't need them till you start doing runs.
Godskin Swaddling Cloth
Taker's Cameo
Rotted Winged Sword Insignia.
R1 spam for tons of damage and free HP.
Add an ash of war with multiple hits and become unkillable.