IMO, this game will come down to who wins the battle in the trenches. The Patriots, hopefully, have found their five starters on the o-line and the unit will look to to build momentum this Sunday against a darn good Bills defensive front.
Offensively, I'd like to see a similar game plan to the one from this past Sunday, using more 12 personnel and Develin as an H-back. True, it would philosophically be attacking a perceived strength of the Bills defense, but I feel that in a hostile environment, it is important have a good mix of the running game in there early, as well as more max protection schemes against a good pass rushing front. If the Patriots can rush for over 200 yards against the Bengals, then I do not see why they can't be successful against the Bills, albeit probably not to the extent we saw a couple days ago.
Defensively, I'd like to see the Patriots continue to play more man press on the outside, disrupt the routes and timing with Orton and his receivers.
The run defense was pretty good against the Bengals, who have a better rushing attack than the Bills. The front seven will have to play disciplined, of course, but hitherto, the Bills offensive line has been mediocre opening holes in the running game, IIRC.
If the Patriots jump out to an early lead, they could get a little more cavalier with the blitzes, and take some more chances to create turnovers that could put the game/crowd away early.
I think Orton is the kind of check-down/game manager that will take what the defense gives and minimize risks. Going back to the types of defenses we primarily saw earlier in the season would work to his advantage.
All in all, if the Patriots play more man press schemes between the 20s and save some of their zone packages if/when the Bill break the red zone, I think that is how it should be done against the Bills offense.
The Patriots no longer have the difference makers on offense to just show up and light up the scoreboard. But they can be just as successful if they win the LOS and execute their assignments in all three phases of the game.