Yeh... into what impedance?
High voltages are common in high speed optics and particle accelerators. Such applications are usually more concerned about working at all, than cost or efficiency, so the solutions are usually brute-force, like ramming a high voltage pulse down a 50 ohm coax (200V into 50 ohms is 4A peak), or whatever impedance is necessary for the desired physical effect (usually the load is a small capacitance, so the rise time from a 50 ohm source is acceptable).
If brute force and off-the-shelf is acceptable, then any wideband 1kW amp will do. I've probably seen Amplifier Research racks that can do that.
Tim