We just got back from Italy a couple weeks ago, and we assumed we were going to get these in Rome. However when we asked at our hotel's front desk where to get them the guy said that they're not as useful as everyone thinks they are and not to bother, and I don't think we missed it. We never took the metro (just not convenient from our hotel), and we only took the bus a few times (it doesn't run in big chunks of the city). We had made reservations to have the 3rd tier/underground Colosseum tour ahead of time, and we bought our tickets for the Colosseum/Forum/Palantine Hill at the Forum entrance, which had no line. We also didn't go to the Borghese Gallery.
Also we did a small group/private tour of the Vatican and it was pricey but completely worth it. We were there 2 days after Easter so the lines outside were insane, but we got to see the Sistine Chapel with just a few other people and the guide was really helpful. www.walksinsiderome.com/en/tour/early-morning-vatican-tour-private.html
Travel is fatal to prejudice, bigotry, and narrow-mindedness, and many of our people need it sorely on these accounts. Broad, wholesome, charitable views of men and things cannot be acquired by vegetating in one little corner of the earth all one's lifetime. Mark Twain
In 2010, we bought our Vatican tickets online the day before (need a printer) and were able to skip the lines (though we didn't realize we could skip the line at first, so we ended up waiting longer than we should have). We also did online tickets for some other places - I think Palantine Hill was tied with the Forum and Colosseum in one ticket, so no lines at all.