Handwork on a shirt is purely about artisanal detailing. In fact, Fabio Borrelli himself once said that handwork makes a shirt more fragile, which is why you can't have a shirt that's completely handmade - it'll fall apart after two washes. It also has nothing to do with fit.
At a certain price point, unless you're interested in collecting shirts like Pokemons (collect them all!), the practical route seems to be just going custom. CEGO, WW Chan, and Ascot Chang will all make you wonderful shirts for about $150. The fabrics on Ascot Chang's shirts get much better once you hit $200-250, but for many of the OTR shirts mentioned here, that's not much more money.