The people that have projects directed at "companion" diagnostics seem to be on the correct path. I am not aware of any other area that can offer this enhanced revenue/profit profile.

I really don't anticipate the lab paying for a better glucose or sodium test. If anything, the reimbursement for routine tests are going to continue to decline....which will subsequently reduce investment.

The market is certainly facing challenges. Developing counties - Asia, South America etc - are growing faster than Europe/North America/Japan/Australia. My employer (not an R&D company)is doing very well with old and manual technologies in India, Brazil, China. Regulatory pressures are popping up in more countries now. Australia just started registration for all IVDs and New Zealand will follow soon. These are relatively small, but sophisticated markets and this will be a barrier to new players and a protection for those already established. Manufacturers of testing systems with high equipment $/consumables $ will have find new ways to generate ongoing revenue. Expect to see more service products and software/lab management/consulting products.
As for development of new technologies - R&D scientists need to learn to develop what the clinical lab scientists want/need to make their lives easier instead of developing clever stuff because they can.

Well, unless people a suddenly going to get better without medicine, I'd say it'll be ok. There's peaks and troughs, and spending cycles, and we're at a low ebb, but it'll be back. Companies only want to satisfy shareholders and short term timescales.