From a design standpoint it is not really a cheap thing to do.
GDDR5(X) is an exception since that was specifically designed to work with GDDR5 controllers, the X is for Extended.
GDDR6 will not be so lucky.
Actually 375W is plenty, the problem is that the GPU is HEAVILY overvolted.
Gamer's Nexus has a video up on this
HERE!
It is highly likely that adjustments will be made in drivers to lower this, GN managed only 268W @ 1600MHz stable along with temps under stress testing @ 50-something max, granted @ 3,5K RPM fanspeed though, but this can be achieved with less as well.
As far as recommended PSUs go... not that hard to understand as both AMD and nVidia play with a lot of safe margin, AMD's is just bigger.
You can easily run an OCed 7700K to 5GHz with all power settings cranked to insanity on the FE with a 600W PSU.
That's an added 150W right there on top of the FE's power drain.
Most people that aren't builders have horrendous shit PSUs, that's why the increase as the 12V rail(s) will be loaded pretty heavily.
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Power cost between a GTX 1080 and R9 290X @ 300W were calculated multiple times on this forum and the difference in a year ended up being 15 - 20 USD, that's 150W vs. 300W for 8 hours a day @ 100% for 365 days in the year.
Also an 850W+ PSU is not going to command a 500 USD premium... where the hell did you get that from?
Most people with this class of hardware most deffo have 750W or higher from a proper brand, they will have plenty of power with that.
Though yes it is a con in comparison, NQA, simply saying that it really isn't as big as people make it out to be.
I can actually link you budget cases which host plenty of space, for example in an mITX form factor the Cooler Master Elite 130 will do.
That's between 30 - 40 USD case, regardless the blower style will work in more cases than you give it credit for BECAUSE it's blower style.
Had it been the standard you might've had a point but then we come back to the following:
What person will put this class of card in a budget environment with budget gear?
You really can't make assumptions on devices that aren't meant for the low end that will drop in a 1K+ card.
Now when it comes to RX Vega... we simply don't know yet, of course it's related but changes may have been made.
Just wait it out and see from the launch and reviews.