Having recently completed Tec 50, I can understand the need for a separate course.
Handing the two deco tanks, and doing gas switches at 70 and 20 feet, plus switching back to back gas between switches and air breaks requires a lot more proficiency than might expected at the Tec 45 level.
All that while getting the usual exercises of wrong gasses, ooa, leaking valves, and valve drills, etc.
I did the last two dives on trimix. I think helium is too expensive to do open circuit trimix. If I ever go deeper, it will be with a rebreather.