Forget about subsequent playthroughs, they need to make the first playthrough not be awful. :p It's also easier to plan builds around items when you know where they are on multiple playthroughs. They could also make items unique to a second, third and so forth playthroughs. But the static uniques should always be found in the same place.
The problem is the level scaling of the random items, though, not exploration or playthroughs. Randomization is rationalized on too many shaky grounds that I don't think hold up AND they mess up not only the balance between them and uniques, but also the balance of the game. It's far easier to balance around non-random items. I thought DA:O had this right, btw.
