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Mine is holding up just fine. No complaints. 32,000 miles on it right now.
I'm not sure if you can justify the difference in price. I mean, it's not like I can feel a huge difference in power ( 475 vs 500 hp) Yeah, I'm sure if I lined up at a red light next to a SO, My HO would beat them to the next light. But by how much?
I bought it mostly in the hopes that its ability to handle excess heat would buy me longer life expectancy since I tow a lot.
Mine is a F350 Long bed. with 3.31 gears and Leveled on 35" tires. It does get about 2 mpg better highway mileage than my 2020 truck did ( 3.55 gears and SO engine) And I get .5 to 1.0 better fuel mileage towing my 13,000 lbs trailer. I decided I would try the 3.31 gears. My 2011 truck had 390hp and 3.55 and pulled same trailer just fine. I figure 13 year newer truck with 110 more hp and 10 speed vs 6 speed, should handle the 3.31 gears and it does.
The 2023 and newer trucks do consume more DEF than previous trucks. I think that is mainly because they do run hotter. My 2020 would occasionally hit 1300° towing up 7% grades, My 2023 hits 1450° on same grade with same trailer. My 20 got 450-500 mpg of DEF towing, 23HO gets 350 mpg of DEF towing at best. Sometimes as low as 300 mpg. Empty my 2020 would run 1000 mpg of DEF and the 23 is more in the 850-900 mpg. DEF is cheap. Easy to buy at the fuel stops in my area. I just top it off every 3rd or 4th fill up. When you consider that DEF is $4.00 gallon ( most places around here) and I go 350 mpg of DEF towing vs 31-32 gallons of diesel for towing that same distance. Diesel at $3.30 a gallon = 30¢ a mile and DEF is 1¢ a mile. I can see more variation in my fuel cost, just by what station across the street I fuel at. It's not a financial issue. Just the hassle of putting it in more often.
My advice, If you tow heavy and work the engine, Then I'd probably get the HO for it's ability to handle the heat. Otherwise save the money and just get the SO
Only worth it if you A. want bragging rights, or B. need to tow heavy up grades every day. Of course you have to PROVE it is worth it for bragging rights. Keep in mind that torque management will prevent you from actually using the extra 25HP during a launch. I would not at all be surprised if my Derringer and Pedal Monster equipped 2019 would be just as fast off the line as the HO is. It's a Diesel afterall, all torque, low RPM, meant for pulling, not racing. Now if it is a race up the IKE, then you will see the increased HP and TQ, and have something to brag about.
It's not like when Ford took the 3.5 EB and made an HO version to put in their GT. That comparison proves the HP boost between the two.
I use mine for work, not racing, and no I am old enough not to need bragging rights. I was most interested in the extra cooling in the turbo. I think the SO has as much HP and Torque as the HO as they are stated lower than actual.
I do like my 6.7 H.O. It is very smooth, quiet and really snappy. Neither of the flavors of 6.7 PSD are slouches and they have so much power that you will never tow more than either engine can take despite the "ratings" on them. Remember, back in the 90's the semi tractors were around 500 HP and 1400 Torque yanking 80K all over the US with no problem. The price difference really isn't worth it for 25 HP and 150 Torque but if you can negotiate well or go with an X plan or better it lessens it a bit. Had I not ordered a Tremor, which requires it if you go diesel, I wouldn't have paid the extra money for it.