Melt butter in a large saucepan or dutch oven over medium heat. Add onion and prosciutto. Saute, stirring occasionally, for 2-3 minutes. Add garlic and saute, stirring, for about 30 seconds or until fragrant.

Add tomatoes, vodka, salt, and, and pepper. Stir to combine. Bring to a simmer and then reduce heat to low and allow to simmer for 15 minutes, stirring occasionally.

Meanwhile, bring a large pot of salted water to a boil and cook pasta al dente according to the package directions. Drain and reserve ½ cup of pasta water.

Add parmesan cheese, heavy cream, basil, and oregano to the sauce. Stir until combined and cheese has melted, about 1 minute. Remove from heat.

Add cooked pasta to the sauce and toss to coat. Thin sauce with reserved pasta water, if needed. Serve garnished with parmesan cheese and fresh basil, if desired.