From someone who uses both C++ and C# on a regular basis, my experience has been that the difference is fairly significant, not just 4%. That aside... you ask who cares? Examples:
Demanding Applications
If your app is extremely large, complex, or graphically intensive, you can probably benefit from a native performance boost. There's a reason office suites and graphics programs are written in C or C++. Games, of course, fall into this category as well.
Simulations
In scientific simulations, there's no such thing as "fast enough". These guys still require supercomputers on occasion, and you can bet they're concerned with the efficiency of their code, since they typically have to rent time on them.
Small-form Devices
For more computationally constrained platforms, such as in tablets, phones, and now even watches or other in-home smart devices benefit from improved speed and tighter control of memory. Also, keep in mind that lower CPU usage means more efficient battery use, which is critical for many small devices.
Large-scale Server Applications
For server-side applications, run-time efficiency can actually trump programmer productivity in importance when scaling up to very large numbers of users, like Google, Facebook, Microsoft, or Amazon has to do. A 10% increase in efficiency leads directly to a non-trivial savings in power costs of your server farm, so in these scenarios, efficiency can be very important. Of course, when Microsoft is renting you it's servers, it's more than happy to have you use C#, since you're the one paying for the servers. My bet is that their own command and control code is completely native.
Today's programming world is especially diverse - much more so than it used to be. Not everyone is writing business apps for desktop PCs.