Two of Barbie's leading designers were killed in a horrific head-on collision on an Italian motorway after an 82-year-old made a U-turn and travelled seven kilometres down the wrong lane.

Artistic duo Mario Paglino, 52, and Gianni Grossi, 48, were travelling in an SUV on the Turin-Milan highway near Mesero when the elderly man driving a Peugeot 207 collided into them, with both vehicles travelling at approximately 130 km/h.

Four people were killed in the incident including the 82-year-old driver, Egidio Ceriani, designers Paglino and Grossi, as well as a 38-year-old banker who the pair were travelling with, Amodio Giurni.

Giurni's wife, Silvia Moramarco, 37, who was also a passenger in the SUV, was the sole survivor and was airlifted to Niguarda Hospital in Milan in critical condition.

The elderly man realised he missed the toll booth on the Turin-Milan highway, so turned around and re-entered the motorway in the wrong lane, before colliding with the SUV at high speed, according to traffic police officers.