We have an Allison MD-3060 in our 2001 International 4700. This is how we speced the truck which we bought new. The trans has 6 speeds (top 2 are OD), but ours is configured as 5 speed. With the 230 hp. DT-466E engine we are currently getting 9.36 mpg. We do a fair amount of local cartage and it sure is nice in city driving, not to mention going through constuction areas or around a wreck.
Yes, the maintainance is more costly. I was a mechanic for 30 years, so I have been doing most of the PM myself. I went to the Trans Synd brand of synthetic oil which is good for 100,000 miles in line haul type service, but it costs $30/gallon and takes 5 gallons to change + the $80 filter kit. The original cost of this trans over a 5 speed manual is about $8,000, I'm not sure how much it will add to the resale.
As to braking, we also have a Jake exhaust brake which is interfaced to the trans computer, so it down shifts when the jake comes on. The torque converter is in lockup in 2nd gear and up, so the braking is pretty good. I can go down Mount Eagle and never apply the service brakes.