Make items in chest appear with 200% starting charges.

The toolboxes are mainly why I want chest opening to be faster (and because medkits are nerfed now it would be more acceptable - I didn't think it would be fair with the old medkits). Without addons, any toolbox you get from a chest saves you less time on a generator than you spent opening the chest (even if we exclude the time spent traveling to a chest - the 10 seconds to open a chest + the couple of seconds afterward to pick up that item is greater than what a Commodious saves you on a gen, and any other toolbox without addons would save less time) so unless you pull off a sabotage play you likely won't gain anything of value from that toolbox.

If we reduce the base time to open a chest, then I'd love the idea in the OP as a perk if it was something like this:

"Reduces your chest-unlocking speed by (some amount that makes it take slightly longer to open a chest than it normally takes now). When you pull an item from a chest, you gain 65/70/75% increased efficiency when using that item, until it is depleted."

While this isn't technically adding more charges, it means if you are willing to spend a bit longer to get an item, then for the cost of offsetting the buff to make chests faster you can make it a really good item by making its existing charges worth a lot more and it wouldn't be able to get out of hand with BTL since it would deactivate once the item is out of charges. 75% increased efficiency means for every 1.75 charges that would normally be used, you will only use 1 charge, effectively making the item last 75% longer than normal. Combining this with Streetwise would allow 2 full self-heals with 1 medkit (since then you'd have 100% which cuts the number of charges you use in half), which for 2 perk slots I think is perfectly fine.

2 perks for 2 not even quick and limited heals (if you even get midkit instead of green key)? What would be the case compared to self care+botany?

Nope, no debuffs. If it should be beneficial in a niche scenario, it has to work on it's own and provide you with at least something more then plot twist does right now (and higher efficiency for every item from chest without any malus would just about make it gamble perk that can screw you over with map/key/brown toolbox, vs being worth it with medkit or strong toolbox).

You need to compare it to existing perks that are being used. Otherwise it's another territorial imperative or current pharmacy.

Right. Because using all those perks has no cost and is definitely better then MfT+UB+hope+WoO....

Each slot is expensive thing. Using another perk slot just to guarantee an item and having 2 slots for 200% charges? Totally not worth it. Especially because you can use different perks for same benefit and without wasting time finding/running to/opening cgest/picking up item.

If you compare just 200% medkit with sc+botany, then sure. But you are leaving out the need to go and find/open the chest and then pickup and maybe even move to less exposed spot then that chest on top of the hill in the middle of the map.

This does not even include chests being limited. Or as we spoke you getting an item you didn't wish for (be it even flashlight that can be used in comparison to just useless green keys).

So once again - why would you ever wish to take this new perk + streetwise over something much more reliable with SC+botany? What niche would your combo occupy and make it better in that case? Because I see none.

Ideally, I’d like it if keys and maps were more useful on average, possibly even combine them into one item to make them better. As it stands, I agree with you that is a major downfall with a perk like this. If part of the risk is that you don’t know what item you’ll get, that item should at least be something useful.

The Streetwise combo was just an example. You would not need to use it to still greatly increase the value of your toolbox or get extra medkit charges you can either use on a teammate or heal yourself as much as possible then let someone else top it off. But tbh, the only reason I felt uncomfortable making it 100% was that it can be used more than once. Honestly if it was a one-time use 100% would probably be fine and that may make the perk more appealing overall.

Regarding Overwhelming Presence, it’s bad because not only is the effect niche, it is almost entirely out of the killer’s control. Unless you see a survivor trying to heal, or they blind you with a flashlight (and there’s a better perk to counter flashlights), you have no idea if or when the perk is actually doing anything. You put it on and…you hope it does something. And if you want to counter medkits, Coulrophobia, a perk that works under the exact same conditions as Overwhelmimg, is usually better at that.

This is why I also don’t like perks such as Better than New that much for example. You heal someone to give them a bonus but you have no idea where or if that bonus is actually making any meaningful difference. Plus 16% is not that much and doesn’t apply to that many actions.

This new perk on the other hand, is more in the survivor’s control and its effect is more visible to them. Not entirely, because there is the randomness of chests, but on average, you know what you should expect to get out of it (in a perfect world where we don’t have completely useless items which is a problem that should be addressed).

Pharmacy would need tweaking, yes. But Residual Manifest and Scavenger can only get those items via rummaging, which could be made the exception to this idea. Apply the same to Appraisal for good measure.

Personally I wish Ace in the Hole was made partially basekit, which all chest items having a low chance to spawn with add-ons, usually only one (rarely two) and mostly common add-ons. Tie Luck to it because that does nothing except affect self-unhooking and that's disappointingly niche. Then make Ace in the Hole greatly increase the Luck tied to opening chests, while Up the Ante increases Luck tied to self-unhooking, and Luck Offerings affect both.